Clinical Images  |   February 2018
Aspiration of Dental Crown
Author Notes
  • From Lakeland HealthCare in St Joseph, Michigan. Dr Lopez is a third-year resident. 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Frank A. Lopez, DO, Lakeland HealthCare, 1234 Napier Ave, St Joseph, MI 49085-2112. E-mail:
Article Information
Imaging / Pulmonary Disorders / Clinical Images
Clinical Images   |   February 2018
Aspiration of Dental Crown
The Journal of the American Osteopathic Association, February 2018, Vol. 118, 124. doi:
The Journal of the American Osteopathic Association, February 2018, Vol. 118, 124. doi:
An 86-year-old woman presented to the pulmonology department following a 4-month history of a progressive nonproductive cough, wheezing, and exertional dyspnea. A plain-film chest radiograph demonstrated a foreign body in the lower lobe of her right lung (image A). Symptoms began 1 week after a tooth extraction, during which a gold crown on an adjacent tooth was dislodged and presumably ingested. Chest computed tomography confirmed a foreign body in the basal segment of the right lower lobe. Subsequent flexible bronchoscopy revealed a metallic-appearing object in the right bronchus intermedius (image B), which was successfully extracted via bronchoscopy using a basket instrument for renal stones. 
Tracheobronchial foreign body aspiration is a rare occurrence among adults.1,2 Clinical manifestations of distal airway obstruction include chronic cough, fever, hemoptysis, chest pain, and wheezing, which can be further complicated by postobstructive pneumonia and atelectasis.1,3 Flexible bronchoscopy serves as a diagnostic and therapeutic modality in the management of lower airway obstruction.1,4 
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Boyd M, Chatterjee A, Chiles C, Chin RJr. Tracheobronchial foreign body aspiration in adults. South Med J. 2009;102(2):171-174. doi: 10.1097/smj.0b013e318193c9c8 [CrossRef] [PubMed]
Hu X, Lee JS, Pianosi PT, Ryu JH. Aspiration-related pulmonary syndromes. Chest. 2015;147(3):815-823. doi: 10.1378/chest.14-1049 [CrossRef] [PubMed]
Swanson KL. Airway foreign bodies: what's new? Semin Respir Crit Care Med. 2004;25(4):405-411. doi: 10.1055/s-2004-832713 [CrossRef] [PubMed]