inforMED
InjuryEMB

DENTEK TEMPARIN TEMPORARY REPAIR 2.64 G

Received Nov 26, 2024

Report 1719513-2024-00047 · MDR key 20784393

Device

Generic name

Zinc Oxide Eugenol

Model number

NA

Catalog number

00012303606G

Lot number

2307EZAZ

Product problems

  • Adverse Event Without Identified Device or Use Problem
  • Adverse Event Without Identified Device or Use Problem

Patient

62 YR · Male

  • Tooth Fracture
  • Tooth Fracture

Narrative

Description of Event or Problem

INITIAL ((B)(6) 2024): THIS SERIOUS CASE REPORTED VIA TELEPHONE REFERS TO A 62 YEAR-OLD MALE CONSUMER WHOSE MEDICAL HISTORY, CONCOMITANT MEDICATIONS AND ALLERGIES WERE NOT REPORTED. ON (B)(6) 2024 THE CONSUMER APPLIED DENTEK TEMPARIN TEMPORARY REPAIR FOR A FILLING THAT CAME OUT AND PIECES OF HIS TOOTH CAME OUT. HE ADVISED THAT HE APPLIED THE PRODUCT BEFORE BED AND WOKE UP TO FIND PIECES OF THE PRODUCT COMING OUT AS WELL AS PIECES OF HIS TOOTH. HE WENT TO THE DENTIST AND HAD THE TOOTH EXTRACTED. THE DENTAL NOTE SUGGESTS THAT THE CONSUMER PRESENTED WITH A FRACTURE IN TOOTH #31 AND A LARGE ABSCESS, THE TOOTH WAS NOT RESTORABLE. THIS CASE OUTCOME IS RECOVERED/RESOLVED. MEDDRA VERSION 261. TOOTH FRACTURE: UNEXPECTED. ACCORDING TO THE COMPANY REFERENCE SAFETY INFORMATION.