Intraoral management of latrogenic tooth displacement: A report of two cases and a brief review of literature

Chattopadhyay, Abira; Hossain, Arif; Chatterjee, Aritra; Hussain, Mohsina; Barman, Sanjit; Raha, Anirban

doi:10.4103/ccd.ccd_384_20

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…The combination of orthopantomography (OPG) and CT scans allowed for precise localization of the displaced fragment. While radiographs and tomography images are valuable for seeking the exact localization of the displaced fragment, a bimanual examination is helpful in locating tooth fragments 17 . By carefully palpating the affected area, the dental surgeon can ascertain the depth and position of the fragment within the submandibular region.…”

Section: Discussionmentioning

confidence: 99%

“…While radiographs and tomography images are valuable for seeking the exact localization of the displaced fragment, a bimanual examination is helpful in locating tooth fragments. 17 By carefully palpating the affected area, the dental surgeon can ascertain the depth and position of the fragment within the submandibular region. This tactile feedback enhances the surgeon's ability to plan the surgical approach and minimize the risk of further displacement during extraction.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

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Application of Cone Beam Computed Tomography in Risk Assessment of Lower Third Molar Surgery

Leung

Hung

et al. 2023

Diagnostics

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Risks of lower third molar surgery like the inferior alveolar nerve injury may result in permanent consequences. Risk assessment is important prior to the surgery and forms part of the informed consent process. Traditionally, plain radiographs like orthopantomogram have been used routinely for this purpose. Cone beam computed tomography (CBCT) has offered more information from the 3D images in the lower third molar surgery assessment. The proximity of the tooth root to the inferior alveolar canal, which harbours the inferior alveolar nerve, can be clearly identified on CBCT. It also allows the assessment of potential root resorption of the adjacent second molar as well as the bone loss at its distal aspect as a consequence of the third molar. This review summarized the application of CBCT in the risk assessment of lower third molar surgery and discussed how it could aid in the decision-making of high-risk cases to improve safety and treatment outcomes.

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Intraoral management of latrogenic tooth displacement: A report of two cases and a brief review of literature

Cited by 2 publications

References 9 publications

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

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

Application of Cone Beam Computed Tomography in Risk Assessment of Lower Third Molar Surgery

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