Rare Complication in Third Maxillary Molar Extraction: Dislocation in Infratemporal Fossa

Battisti, Andrea; Priore, Paolo; Giovannetti, Filippo; Barbera, Giorgio; D’Alessandro, Francesco; Valentini, Valentino

doi:10.1097/scs.0000000000003628

Cited by 14 publications

(18 citation statements)

References 7 publications

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“…The endoscopic approach is a less destructive procedure proposed for the retrieval of displaced teeth in the infratemporal fossa: it provides a constant direct view on the field and the displaced element. Battisti et al removed a third molar displaced in correspondence of the pterygo-maxillary suture by the use of an endoscopic probe under general hypotensive anaesthesia through the primary surgical access in few minutes (23).…”

Section: Discussionmentioning

confidence: 99%

Immediate or delayed retrieval of the displaced third molar: A review

Nardo¹,

Mazzucchi²,

Lollobrigida³

et al. 2019

J Clin Exp Dent

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BackgroundThe displacement of a third molar is a rare occurrence, but it could lead to serious and/or life threatening complication. Aim of this review is to understand the most correlated causes of displacement and the possible solutions proposed in literature to avoid and solve this complication for maxillary and mandibular third molars at the appropriate time.Material and MethodsA search for “third molar displacement” was performed by using Pubmed database. Articles referred to soft tissues displacement, from 1957 to 2018, were included in the review. The references lists of all eligible articles were examined and additional studies were added to the review only if indexed on Pubmed. All the articles on maxillary sinus displacement and the dislocation of dental fragments or surgical equipment were excluded.ResultsFrom a total of 134 results, 68 articles were examined for satisfying inclusion criteria. 18 articles were excluded because not inherent with the topic; 19 articles on infratemporal space, 11 on sublingual space, 9 on submandibular space, 11 on lateral pharyngeal space displacement were considered congruent for the review and included.ConclusionsThe displacement of the third molar in deeper tissues could be avoided by the use of proper surgical procedures and instrumentarium. If displacement occurs, and the operator could not reach the tooth in safe conditions, the patient should be immediately referred to a maxillo-facial surgeon, because of the possibility of further displacement or the onset of hazardous or potentially fatal infections in vital regions. Key words:Third molar, wisdom tooth, maxillary, mandibular, displacement.

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Section: Discussionmentioning

confidence: 99%

Immediate or delayed retrieval of the displaced third molar: A review

Nardo¹,

Mazzucchi²,

Lollobrigida³

et al. 2019

J Clin Exp Dent

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“…5 There is no consensus regarding the management of this complication with various controversies such as, immediate versus delayed removal, LA versus GA and intra-oral versus extra oral approach. 6,7,8,9…”

Section: Discussionmentioning

confidence: 99%

An unprecedented displacement of root piece in the infratemporal fossa: a case report

et al. 2021

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There are various reports of displaced maxillary third molar in the infratemporal fossa (IFT) in the literature. However there are no reported cases of a displaced root piece in the IFT. Here we have described a case of an accidental displacement of root piece of maxillary third molar into the IFT by a resident due to lack of surgical judgement and how this case was investigated and managed by our surgical team. There is no specific protocol for management of such complication in literature. The aim of this article is to identify the errors which lead to displacement of tooth in IFT and to establish a stepwise protocol to manage the same. We have highlighted a few basic steps for young practitioners to avoid such complications and also to manage them if at all they do occur.

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“…The most common space for displacement of a maxillary third molar is reported to be infratemporal fossa. 3,4 The PtMS lies inferior to infratemporal fossa and is separated from it by the lateral pterygoid muscle, which is a horizontal muscle whose superior head originates from greater wing of sphenoid and inserts into temporomandibular joint and inferior head originates from the outer surface of the lateral pterygoid plate and inserts into the pterygoid fovea. This muscle forms the floor of the infratemporal fossa and the roof of the PtMS and it is interesting to note that the maxillary third molar tooth should travel either between the two heads or the muscle or slide anterior to the muscle to be displaced into the PtMS (Figure 2).…”

Section: Discussionmentioning

confidence: 99%

Management of iatrogenic displacement of maxillary third molar into pterygomandibular space: case report

et al. 2020

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<p>Third molar surgery is the most common minor oral surgical procedure performed in dental clinics. Displacement of maxillary third molar tooth into adjacent spaces such as infratemporal fossa, maxillary sinus has been reported earlier. We present an unusual case of iatrogenic displacement of maxillary third molar into pterygomandibular space. A 24 year old dental undergraduate reported to Department of Oral surgery with complaints of trismus and swelling in the check region after unsuccessful attempt at extraction of maxillary right third molar tooth. Computed tomography scan localized the tooth in the pterygomandibular space. A surgical removal of the displaced tooth was performed under general anesthesia. Displaced tooth was approached by an intraoral vertical incision along the anterior border of ramus of mandible. Correlating with computed tomography scan, tooth was located and removed followed by suturing of the surgical site. A good knowledge of the operating area and adjoining spaces is essential to avoid iatrogenic damage to tissues during minor oral surgery procedures. Adequate exposure and appropriate instrumentation during surgery can prevent undue complications and ensure quality patient care.</p>

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Rare Complication in Third Maxillary Molar Extraction: Dislocation in Infratemporal Fossa

Abstract: Removing tooth from the IF could be burdened by serious risk of bleeding and/or nerve injury. The endoscopic approach provides direct view of the IF reducing morbidity.

Cited by 14 publications

References 7 publications

Immediate or delayed retrieval of the displaced third molar: A review

Immediate or delayed retrieval of the displaced third molar: A review

An unprecedented displacement of root piece in the infratemporal fossa: a case report

Management of iatrogenic displacement of maxillary third molar into pterygomandibular space: case report

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