Displaced lower third molar tooth into the submandibular space: Two case reports

Köse, İbrahim; Koparal, Mahmut; Gunes, Nedim; Atalay, Yusuf; Yaman, Ferhan; Atılgan, Serhat; Kaya, Gurkan

doi:10.4103/0976-9668.136274

Cited by 14 publications

(12 citation statements)

References 5 publications

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“…Accidental displacement of the mandibular third molar tooth or fragments into the submandibular space is very rare, with a reported incidence of less than 1% 2 . The first case of iatrogenic submandibular displacement was reported by Ho 24 in 1980; to date, only 12 reports have been published 1 3 4 7 22 24 25 26 27 28 29 30 . ( Table 1 ) In most of the cases, the major predisposing factors contributing to displacement were a thin lingual plate and uncontrolled maneuvering due to a lack of basic surgical knowledge.…”

Section: Discussionmentioning

confidence: 99%

“…( Table 1 ) In most of the cases, the major predisposing factors contributing to displacement were a thin lingual plate and uncontrolled maneuvering due to a lack of basic surgical knowledge. However, number of patient and operator related factors have also been reported to potentially contribute to displacement 1 3 4 22 25 .…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the operator may be faced with legal implications related to this unsuccessful surgery 12 . Thus, it is prudent to stop the operation, inform the patient about the condition, and refer the patient to a maxillofacial surgeon as soon as possible 22 .…”

Section: Discussionmentioning

confidence: 99%

“…Access to the submandibular space is difficult because of the anatomical structures enclosed by this space 31 . Many surgical approaches, including trans-oral approaches via general 4 7 22 26 or local anesthesia 3 25 27 and extra-oral approaches via local 25 or general anesthesia 1 have been reported. In 2002, Yeh 28 reported a modified technique using a combination of intraoral and extraoral approaches to facilitate the retrieval of displaced teeth and fragments.…”

Section: Discussionmentioning

confidence: 99%

“…The maxillary sinus and submandibular spaces are the two most commonly affected. Since so few cases have been published, no consensus has yet been reached in terms of the optimum management protocol that can be applied in all circumstances 22 23 .…”

Section: Introductionmentioning

confidence: 99%

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Persistent lingual paresthesia caused by a displaced tooth fragment: a case report and literature review

Torul

Kazan

Bereket

et al. 2017

J Korean Assoc Oral Maxillofac Surg

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Accidental displacement of the third molar tooth or its fragment into the anatomical spaces is a rare but potentially serious complication. The most common sites of mandibular third molar displacement are the sublingual, submandibular, and pterygomandibular spaces. Removal of a displaced tooth or its fragments from these spaces may be difficult due to poor access and the vital structures involved in these spaces; therefore, removal may result in permanent damage. This article is intended to provide a concise update of the reported cases of submandibular displacement and to present a case of intraoral management of mandibular third molar root fragments that were displaced into the submandibular space.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Persistent lingual paresthesia caused by a displaced tooth fragment: a case report and literature review

Torul

Kazan

Bereket

et al. 2017

J Korean Assoc Oral Maxillofac Surg

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A rare case of mandibular third molar displaced into submandibular space: A complication of mandibular third molar extraction

Nadeem,

Vohra,

Ahsan

et al. 2023

Clinical Case Reports

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Key Clinical MessageAccidental displacement of mandibular third molars or their roots into neighboring anatomical spaces, notably the submandibular region, during extraction, is a rare but significant complication. Comprehensive preoperative assessment, meticulous surgical techniques, and precise radiographic imaging play pivotal roles in successful management. Adhering to established protocols is imperative to mitigate potential complications and ensure optimal outcomes.AbstractIn this report, we emphasize the critical importance of comprehensive preoperative preparation to tailor surgical approaches and techniques in accordance with recognized surgical principles. Oral and maxillofacial surgery often involves the extraction of impacted lower third molars, a common surgical procedure. However, this procedure can present potential complications such as hemorrhage, tissue damage, infection, alveolar osteitis, paresthesia, and mandible dislocation. Unintentional displacement of a mandibular third molar or its root fragments into adjacent anatomical areas, such as the maxillary sinus or submandibular space, is a rare intra‐operative exodontia complication that is seldom documented. A 44‐year‐old male patient presented with complaints of pain, discomfort, and limited mouth opening. He had previously attempted to have a tooth extracted, but the procedure resulted in a misplaced tooth. A painful, indurated swelling was observed at the patient's left mandibular angle. Radiographic analyses revealed a radiopaque lesion resembling the third molar tooth root. Utilizing orthopantomography and CT images, the misplaced root in the left submandibular region was accurately located. The tooth was successfully extracted following the elevation of a lingual flap. The patient was prescribed antibiotics and painkillers for 7 days, and he reported an uneventful recovery with no complications on the eighth postoperative day. Accidental displacement of lower third molars or root fragments into neighboring anatomical areas is a rare but potentially concerning complication. Common sites of displacement include the submandibular, sublingual, and pterygomandibular spaces. Risk factors for displacement encompass improper use of surgical instruments and variations in patient anatomical characteristics. The ease of extraction can be influenced by various factors, including the degree of impaction, root structure, and dental inclination. Recommended screening examinations include panoramic radiography, intraoral periapical (PA) radiography, and occlusal radiography. Precise diagnosis and localization necessitate radiographic assessments such as CT scans and panoramic radiography. Postoperative care involves administering analgesics, antibiotics, suturing, wound irrigation, and managing potential complications like swelling, discomfort, infection, and nerve damage. Accidental displacement of lower third molars or their roots into the submandibular region is an infrequent yet potential complication. Thorough case assessment and adherence to established protocols for appropriate access, judicious bone removal, and avoiding excessive force are imperative for clinicians in the field of oral and maxillofacial surgery.

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Bucco alveolar bone thickness of mandibular impacted third molars with different inclinations: a CBCT study

et al. 2020

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Displaced lower third molar tooth into the submandibular space: Two case reports

Cited by 14 publications

References 5 publications

Persistent lingual paresthesia caused by a displaced tooth fragment: a case report and literature review

Persistent lingual paresthesia caused by a displaced tooth fragment: a case report and literature review

A rare case of mandibular third molar displaced into submandibular space: A complication of mandibular third molar extraction

Bucco alveolar bone thickness of mandibular impacted third molars with different inclinations: a CBCT study

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