Possible prosthetic complication: a case of a swallowed overdenture in an elderly patient

OBJECTIVES The aim of this article is to present a clinical case of accidental ingestion of a fixed prosthetic restoration (overdenture) by an elderly patient, as an example of a prosthetic complication or accident within edentulous patients. MATERIALS AND METHODS The case of a 95-year-old man who accidentally swallowed his upper dental prosthetic overdenture on implants is presented. For this reason, the patient went to the nearest general emergency department, with respiratory difficulties and dysphagia. Under intravenous conscious sedation and after radiographic examinations that revealed the position of the prosthesis within the upper aerodigestive tract, the patient underwent endoscopy in order to remove the foreign body. RESULTS AND CONCLUSIONS Follow-up showed a normal recovery of the patient, who was not harmed by the event or endoscopy. The accidental presence of foreign bodies in the aerodigestive tract is not an uncommon complication. Most commonly these are food debris such as animal bones or fish bones, but in the elderly patient ingestion of dental prosthesis is even more common. These may cause significant morbidity and occasionally mortality, or local and systemic complications if they linger for long periods within the gastro-intestinal canal, such as GI perforations and peritonitis. The elderly patients who are not self-sufficient are particularly prone to ingesting or inhaling dentures, especially if these lose their correct stability over time. It is therefore necessary to motivate and call these categories of patients to periodic follow-up to assess the stability of the dentures. CLINICAL SIGNIFICANCE Both fixed and removable dentures may represent a special type of inhaled or ingested foreign body that requires the attention of different specialists. It is necessary to observe adequate follow-up after the insertion of dentures or prosthetic appliances, especially in frail elderly patients, in order to avoid accidental detachment and dangerous consequences.