Foreign Bodies in Extraction Socket: An Outcome of Negligence and Proposal of a Classification with its Medico-legal Implications.

BACKGROUND: Removal of tooth is just a routine dental surgical practice, where negligence is a must avoidable contingence. Still, few complications may arise during or after the procedure. One of the rare complications is the breakage of surgical instrument or presence of any foreign body (FB) in extraction socket. This may be due to improper handling of a surgical instrument or using substandard tools, which may lead to breakage of the instrument or any negligence by the patient himself. This negligence can be on various levels, like professionals, manufacturers or patients. All these events may cause serious outcomes pertaining to the medicolegal issues.
PURPOSE: The aim of this study was to classify the negligence in oral surgery for legitimacy with possible management for the retrieval of the FB and discuss various Indian Penal Codes for Medical Negligence according to the Constitution of India and its implications.
METHOD: Diagnosis and surgical retrieval of FB associated with extraction socket were performed in three cases. Incision, flap reflection, identification of FB and successful retrieval followed by suturing under local anesthesia were achieved. Routine medications were prescribed. The FB were sent for stereomicroscopic examination. RESULT: All the patients were followed up after a week, and no complications were observed. Suture removal was carried out, and oral hygiene instructions were given. The FB were found to be piece of lead, broken tip of a dental elevator and broken diamond round bur.
CONCLUSION: The negligence can occur at any stage, and it has its medicolegal aspects. This negligence can be apprehended in front of the Indian Penal Code for Medical Negligence. Hence, a classification is required to understand and subdivide the negligence to find the legitimacy over the medicolegal implications. © The Association of Oral and Maxillofacial Surgeons of India 2020.