Ectopic wisdom tooth at the mandibular ascending ramus

Abstract

This case has been presented as a poster presentation at the annual congress of the AGKi (Arbeitsgemeinschaft für Kieferchirurgie), Bad Homburg, on 10th May 2013. The authors disclose any commercial associations, current and within the past 5 years, that might pose a potential, perceived or real conflict of interest. AbstractTwenty to thirty per cent of wisdom teeth are partially or completely retained. A displacement of such teeth into the ascending ramus of the mandible is far less frequent with few reported cases in the literature. The case of a young lady and a review of the literature are presented. A 27-year-old woman was referred to the specialist department by her dentist. At the age of 22, a panoramic radiograph had been taken for an agenesis of the patient's lower left second molar. At this time, the lower left third molar was situated slightly submucosally at the angle of the mandible. In the present radiograph, the tooth had migrated into the ascending ramus of the mandible. Clinically, there was no pain, sensation disorder, disturbed occlusion, limited mouth opening or any other complaint. Due to significant tooth migration within the last 6 years, operative removal of the displaced tooth was recommended. Computed tomography showed that the distal root was in direct relation with the inferior alveolar nerve. Treatment was performed via a transoral approach. Post-operative follow-up was uneventful. This case stresses the importance of long-time follow-up of retained teeth and their immense potential for migration.

Comprehensive analysis of ectopic mandibular third molar: a rare clinical entity revisited

“…The patients with ectopic mandibular third molars were diagnosed at mean age 41.72 years, with a slight female predilection, which is generally with previous reports [ 2 , 31 ]. This epidemiological features are different from the impacted teeth which are commonly detected in much younger ages.…”

“…Moreover, local inflammations support the progressive expansion of cysts and serves as an additional factor to force the migration of the tooth into an ectopic position [ 17 ]. However, some cases are not involved with any pathological lesions, thus other etiological factors in its pathogenesis can’t be ruled out [ 9 , 31 , 39 ].…”

An Infected Ectopic Wisdom Tooth in the Ascending Ramus

“…Further review of patient's previous radiographs taken by the patient's implant dentist may reveal pathological migration however this has not been explored. In any case, ectopic migration of the third molar to such an extent is a rare occurrence [6]. A literature search revealed 28 reported cases in the literature where third molars present high up in the ramus or condylar region .…”

Ectopic Third Molar in Mandibular Ramus: Report of Two Cases and Literature Review

“…A variety of case reports have described ectopic molars in different places on the mandible [1][2][3][4][5][6][7][8]10,[12][13][14][15][16][17][18][19][20][21][22][23][24][25]27,29,30,[32][33][34][35]38]. The etiology of ectopic teeth cannot be easily determined [23].…”

“…The most relevant pathogenesis for ectopic third molar seems to be odontogenic cyst. In the period 1979-2014, the most frequent location of ectopic molars was in the condyle (18 cases) [1,2,[5][6][7][8]10,12,16,21,24,27,29,30,33,35]; 10 were in the ramus [1,3,6,14,17,20,32,34], with only 3 in the angulus [1,4,38], 3 in the coronoid [8,15,25] and 1 on the lower edge of the mandibular corpus.…”