Iatrogenic fracture of lingual plate of bone and Displacement of Mandibular Third Molar into Submandibular Tissue Space. A Case Report.

Document Type : Original Article

Authors

1 Maxillofacial surgery department, Faculty of dentistry, Al Azhar University, Cairo, Egypt.

2 maxillofacial surgery department, faculty of dentistry, Al Azhar University, Cairo, Egypt.

Abstract

Abstract: displacement of impacted third molar tooth or fragment during surgical extraction to adjacent tissue spaces such as submandibular or pterygomandibular is not a common complication. Retrieval of displaced tooth or fragment is complicated by difficult visibility, accessibility and instrumentation. Patient and methods: Referred male patient with displaced decapitated lower third molar tooth into submandibular tissue space. The displaced tooth was retrieved intra orally by raising lingual flap, using local anesthesia nerve block. The tooth was removed safely without complications and wound healing was normal. Conclusion: wisdom tooth removal must be done by an expert surgeon with adequate clinical and radiological assessment to avoid inadvertent complications. In case of iatrogenic displacement of the tooth or fragment into tissue space, computed tomography (CT) is a proper tool to estimate its exact location.
Introduction: Surgical removal of impacted wisdom teeth is common surgical procedure with minimum complications of about 1% of cases which include bleeding, pain, swelling, infection and nerve parenthesis (lingual, inferior alveolar) either temporary or permanent. 1-4 Displacement of wisdom tooth or fragment into tissue space (submandibular or pterygomandibular) is uncommon complication in practice and in literature.5, 6 Iatrogenic displacement of wisdom occur due to lack of experience, improper preoperative clinical and radiographic estimation, improper treatment plan and uncontrolled application of force specially by elevators.7 This case report showing iatrogenic displacement of decapitated lower left wisdom retrieved surgically by intraoral lingual flap approach under local anesthesia.

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