A 23-year-old female with no significant previous medical history presented at the emergency service of our dental hospital following the accidental ingestion of a crown during routine dental treatment. Her general condition was very good, without dyspnea, nausea, vomiting or abdominal pain. Pharyngo laryngo fiberscopic analysis revealed normal, suggesting passage of the foreign body into the esophagus. Plain abdominal X-ray imaging suggested that a sharp crown was in the stomach (Figure 1). Although we performed an urgent esophago-gastroscopy, we failed to retrieve the foreign body because the foreign body had already migrated beyond duodenojejunal flexure. Therefore, we performed the strict observation for the patient till the foreign body is excreted as stool. Fortunately, we could confirm it two days after the accidental ingestion (Figure 2).

Figure 1: Abdominal X-ray imaging.

Figure 2: A crown with loop was observed.

      Although ingested foreign bodies usually pass through the gastrointestinal tract uneventfully, it can sometimes cause serious complications [1]. Therefore, as prevention method of accidental ingestion, our hospital is supposed to tether a crown with dental floss ligature using the loop as the attachment, during dental treatment (Figure 3). In this clinical case, during fitting the crown in oral cavity, dental floss was removed before finishing the procedure due to the difficulty the manipulation, and thereafter an accidental ingestion of crown with loop unexpectedly occurred. Thus, we think that dentist should tether dental floss into the loop during dental procedure.

Figure 3: Prevention method of accidental ingestion in our dental hospital.