Rationale: Although the accidental aspiration of dental implant components is exceedingly rare, it is a high-risk complication because it can rapidly cause life-threatening airway obstruction. We present a case to underscore the need for early recognition and prompt airway evaluation when implant parts are lost during dental procedures. Patient concerns: A 69-year-old woman developed sudden, severe coughing during implant crown placement after an intraoperative crown–abutment assembly became dislodged. The foreign body was not visualized in the oral cavity and was not expelled. Diagnosis: Non-contrast computed tomography of the chest localized the crown–abutment assembly within the bronchial tree. Imaging confirmed an airway foreign body as the cause of symptoms. Interventions: Flexible bronchoscopy under local anesthesia was performed. The crown–abutment assembly was grasped and removed using bronchoscopic forceps. Outcomes: Extraction was successful and uneventful. The patient experienced no postoperative complications. Lessons: Although the incidence is low, implant-related airway aspiration poses a significant risk and warrants heightened clinical vigilance. When an implant component is lost, clinicians should first consider the high-risk possibility of airway obstruction due to a foreign body and actively rule out airway aspiration before assuming the lower-risk possibility of gastrointestinal entry. This approach improves the timeliness and success of emergency management and enhances patient safety.
Xie et al. (Fri,) studied this question.