Unexpected radiopaque foreign bodies encountered in dental practice

Objectives: The purpose of the present study was to determine the presence of radiopaque foreign bodies on oral and maxillofacial radiographs and classify them. Method and Materials: The Study Comment section of the Picture Archiving and Communication System of Chonnam National University Dental Hospital was searched using 30 key words to identify images with radiopaque foreign bodies recorded between November 2008 and March 2017. A total of 503 cases of radiopaque foreign bodies were selected from among the recovered images. The radiopaque foreign bodies were sorted into 19 types, which were subsequently divided into two categories according to whether the foreign bodies were inserted intentionally or unintentionally. The two categories were subdivided into five groups based on the cause of insertion: Treatment, Esthetics, Cultural, Iatrogenesis, and Accident. Results: In this study, the proportions of foreign bodies inserted intentionally (48%) and unintentionally (52%) were similar. When the foreign bodies were grouped based on the cause of insertion, the following frequencies were observed: Treatment, 41%; Esthetics, 7%; Cultural, 1%; Iatrogenesis, 51%; and Accident, 1%. Conclusion: For adequate case management and to avoid unnecessary embarrassment and misinterpretation of unexpected radiopacities, clinicians should be familiar with the various types of foreign bodies and should ensure that detailed patient medical/dental history is obtained. Keywords: accidents, artifacts, esthetics, foreign bodies, iatrogenic disease, radiography