A needle in a haystack: Report of a retained archwire fragment in the pterygomandibular space

This clinical report describes a retained archwire fragment, discovered during a new-patient examination of a young woman seeking orthodontic retreatment. The diagnostic process, care coordination, and patient management decisions are discussed, along with a brief exploration of clinical considerations associated with this incident. A suggested emergency prevention and response protocol is also presented. •An embedded fragment of orthodontic archwire was found during a new patient exam.•Proper management required interdisciplinary care coordination.•Clinical and legal considerations for task delegation and oversight are discussed.•Every clinic should have a protocol to avoid or properly manage such incidences.