Aspiration of a dental implant causing airway foreign body in an elderly patient: A case report

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.