title: Dental root elevator embedded into a subgingival caries: a case report.
abstract: BACKGROUND
  Breakage of surgical instruments is a rare complication. A mistake in operator technique or sub-standard/aged tools could lead to this type of accident. A tooth elevator is an instrument used in minor oral surgical procedures to luxate the tooth or fractured root from its socket. The authors have not found any previously published cases reporting the breakage of a tooth elevator tip which then remained as a foreign body in a hidden caries cavity.
  
  
  METHODS
  A 28-year-old African black male was referred to a hospital in Tanzania for an intraoral radiography. The patient explained that six months previously his mandibular left third molar had been extracted. Whilst the healing process had been satisfactory, he had recently experienced acute oral pain in this region. The dental X-ray showed an image consistent with a piece of broken metal embedded in a distal subgingival caries at the mandibular left second molar.
  
  
  CONCLUSIONS
  Oral and dental surgeons should take particular care when employing metal instruments with strong force in poorly visible areas. A radiographic study should be carried out when instrument breakage occurs. If an unexpected accident takes place during a surgical procedure, the patient must be informed in accordance with ethical codes, and suitable measures adopted to resolve the issue.
authors.affiliation: Departament d'Odontostomatologia, Facultat d'Odontologia, Universitat de Barcelona, Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain. jmiranda-rius@ub.edu.
authors.forename: Jaume
authors.initials: J
authors.lastname: Miranda-Rius
authors.affiliation: Servei d'Odontologia, Hospital Universitari Sant Joan de Déu - UB, Esplugues de Llobregat, Barcelona, Spain. lbrunet@hsjdbcn.org.
authors.forename: Lluís
authors.initials: L
authors.lastname: Brunet-Llobet
authors.affiliation: Departament d'Odontostomatologia, Facultat d'Odontologia, Universitat de Barcelona, Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain. eduardlahor@ub.edu.
authors.forename: Eduard
authors.initials: E
authors.lastname: Lahor-Soler
authors.affiliation: Dental and Oral Department, Soweto General Hospital, Arusha, United Republic of Tanzania. clinicians@kilibarnadental.com.
authors.forename: Ombeni
authors.initials: O
authors.lastname: Mrina
authors.affiliation: Departament d'Odontostomatologia, Facultat d'Odontologia, Universitat de Barcelona, Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain. faramirezr@ub.edu.
authors.forename: Albert
authors.initials: A
authors.lastname: Ramírez-Rámiz
mesh_terms: D000328:Adult; D003731:Dental Caries / Q000000981:diagnostic imaging / Q000473:pathology*; D003762:Dental Instruments / Q000009:adverse effects*; D005881:Gingiva / Q000473:pathology*; D006801:Humans; D008297:Male; D008963:Molar / Q000000981:diagnostic imaging; D011859:Radiography; D014084:Tooth Avulsion; D014081:Tooth Extraction; D014092:Tooth Root / Q000000981:diagnostic imaging / Q000473:pathology*