Transmasseteric antero-parotid approach: a technique adaptation for ectopic subcondylar third molar removal and associated dentigerous cyst enucleation

Dentigerous Cyst Associated with an Ectopic Tooth in the Subcondylar Area: A Case Report and Literature Review

“…These lesions progress slowly and are usually painless, but may cause facial swelling and delayed tooth eruption (Kocer et al, 2002;Ustuner et al, 2003;Buyukkurt et al, 2010). Among the 14 case reports summarized in Table I, the most common signs and symptoms associated with ectopic teeth are facial pain (Medici et al, 2001;Tumer et al,2002;Suarez-Cunqueiro et al, 2003;Wang et al, 2008;Salmeron et al, 2008;Gadre and Waknis, 2010;Iglesias-Martin et al, 2012), facial swelling on the preauricular region or ipsilateral side of the mandible (Tumer et al,2002;SuarezCunqueiro et al, 2003;Salmeron et al, 2008;Pace et al, 2010;Gadre and Waknis, 2010;Scott et al, 2012;Iglesias-Martin et al, 2012;Bowman et al,2014) and trismus (Wassouf et al, 2003;Salmeron et al, 2008;Iglesias-Martin et al, 2012), difficulty in mastication (Bux and Lisco, 1994;Medici et al, 2001). In 3 of the 14 summarized patients, intraoral or extraoral drainage of purulent material have been reported (Salmeron et al, 2008;Pace et al, 2010;Gadre and Waknis, 2010).…”

“…In the treatment of ectopic third molars in the condylar region, several approaches have been used, including an intra-oral approach (Medici et al, 2001;Wassouf et al, 2003;Wang et al, 2008;Gadre and Waknis, 2010;Scott et al, 2012;) an endoscopic intraoral approach (Suarez-Cunqueiro et al, 2003) and an extra-oral approach (Bux and Lisco, 1994;Tumer et al,2002;Salmeron et al, 2008;Pace et al, 2010;Iglesias-Martin et al, 2012;Bowman et al,2014). Among the 14 cases summarized in Table I, 7 (Bux and Lisco, 1994;Tumer et al, 2002;Salmeron et al, 2008;Pace et al, 2010;Iglesias-Martin et al, 2012;Bowman et al, 2014) were by an extraoral approach and 7 (Medici et al, 2001;Wassouf et al, 2003;Wang et al, 2008;Gadre and Waknis, 2010;Scott et al, 2012;) were by an intraoral approach.…”

“…Among the 14 cases summarized in Table I, 7 (Bux and Lisco, 1994;Tumer et al, 2002;Salmeron et al, 2008;Pace et al, 2010;Iglesias-Martin et al, 2012;Bowman et al, 2014) were by an extraoral approach and 7 (Medici et al, 2001;Wassouf et al, 2003;Wang et al, 2008;Gadre and Waknis, 2010;Scott et al, 2012;) were by an intraoral approach. The most commonly used extra-oral approaches are retromandibular (Bux and Lisco, 1994;Pace et al, 2010;Iglesias-Martin et al, 2012) and preauricular (Tumer et al,2002;Salmeron et al, 2008).…”

“…These external approaches have the advantage of good surgical exposure, especially to the body and ascending ramus, to the condylar region, but may result in complications such as cutaneous scar formation, damage of temporomandibular joint components, facial nerve injury in the case of pre-auricular access, or damage of the marginal mandibular branch of the seventh cranial nerve (Medici et al, 2001;Wang et al, 2008;Sanghera and Jones, 2013). However, Bowman et al reported that the transmasseteric antero-parotid Approach (TMAP) reduced the surgical morbidity anticipated with alternative approaches, as it has a low risk of iatrogenic injury to the facial nerve and also reduces the risk of injury to the lingual nerve (Bowman et al, 2014). Although it provides a smaller surgical site, the intra-oral approach helps in avoiding a visible facial scar and injury to the facial nerve (Wang et al, 2008;Iglesias-Martin et al, 2012;Sanghera and Jones, 2013).…”

“…The standard treatment for a dentigerous cyst is enucleation and extraction of the tooth involved (Martinez-Perez and Varela-Morales, 2001;Kocer et al, 2002;Buyukkurt et al, 2010;Bowman et al, 2014). In large cysts, an initial marsupialization to diminish the size of the osseous defect followed by enucleation and tooth extraction has been advocated (Martinez-Perez and Varela-Morales, 2001).…”