Journal of Contemporary Dentistry

Register      Login

VOLUME 9 , ISSUE 3 ( September-December, 2019 ) > List of Articles

CASE REPORT

Persistent Oral Infection Caused by an Iatrogenic Displacement of a Lower Third Molar Root to the Sublingual Space

Naama WA Sousa, Antonia TL de Moraes, Douglas M Guimarães, Ana PG Rodrigues Couto, Lucas R Pinheiro, João de Jesus Viana Pinheiro, André LR Ribeiro

Citation Information : Sousa NW, de Moraes AT, Guimarães DM, Couto AP, Pinheiro LR, Pinheiro JD, Ribeiro AL. Persistent Oral Infection Caused by an Iatrogenic Displacement of a Lower Third Molar Root to the Sublingual Space. J Contemp Dent 2019; 9 (3):155-158.

DOI: 10.5005/jp-journals-10031-1269

License: CC BY-NC 4.0

Published Online: 25-03-2021

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Aim and objective: Describe a case of sublingual displacement of a root of the lower third molar, as well as highlight the importance of using appropriate complementary imaging tests and provide the clinician with information on how to prevent and treat this complication. Background: The displacement of the lower third molar is an accidental event that can lead to serious complications, which is usually the cause of inadequate surgical technique. Case description: A 69-year-old man presented pain and trismus due to local infection 1 month after a tooth extraction. After a misdiagnosis of retained root and surgical exploration, a cone-beam computed tomography (CBCT) showed a displaced root into the sublingual tissues. A surgical procedure under local anesthesia was carried out to easily remove the displaced tooth root, which resulted in complete healing of soft tissues and disappearance of signs of local infection. Conclusion: The use of CBCT is essential for the identification and location of the dislocated tooth and the removal of the fragment, as it allows a three-dimensional assessment providing adequate surgical planning which resulted in complete remission of all symptoms. Clinical significance: Few reports have been published to describe this rare complication of dental extractions that support key points for proper management: (1) the use of three-dimensional imaging for proper evaluation and establishment of exact location; (2) careful surgical planning; (3) precise surgery. Successful tooth removal is the main goal of treatment, which usually results in control of associated signs and symptoms.


HTML PDF Share
  1. Recommendations for third molar removal: a practice-based cohort study. Am J Public Health 2014;104(4):735–743. DOI: 10.2105/AJPH.2013.301652.
  2. Intraoperative accidents associated with surgical removal of third molars. Braz J Oral Sci 2014;13(4):276–280. DOI: 10.1590/1677-3225v13n4a07.
  3. Unrecognised displacement of mandibular molar root into the submandibular space. Br Dent J 2010;209(6):279–280. DOI: 10.1038/sj.bdj.2010.816.
  4. Complications after extraction of impacted third molars - literature review. J IMAB - Annu Proceed (Scientific Pap) 2016;22(3):1202–1211. DOI: 10.5272/jimab.2016223.1202.
  5. Intraoral management of displaced root into submandibular space under local anaesthesia - a case report and review of literature. Saudi Dent J 2014;26(4):181–184. DOI: 10.1016/j.sdentj.2014.05.004.
  6. Preoperative imaging procedures for lower wisdom teeth removal. Clin Oral Investig 2008;12(4):291–302. DOI: 10.1007/s00784-008-0200-1.
  7. Accidental displacement of third molars; Report of three cases, review of literature and treatment recommendations. Oral Surg 2013;6(1):2–8. DOI: 10.1111/ors.12013.
  8. Accidental displacement of mandibular third molar roots into the pterygomandibular space. Niger J Clin Pract 2018;21(8):1075–1077. DOI: 10.4103/njcp.njcp_427_17.
  9. Accidental displacement of mandibular first molar root into buccal space: a unique case. J Stomatol Oral Maxillofac Surg 2018;119(5):429–431. DOI: 10.1016/j.jormas.2018.04.004.
  10. Iatrogenic displacement of lower third molar roots into the sublingual space: report of 6 cases. J Oral Maxillofac Surg 2012;70(2):107–115. DOI: 10.1016/j.joms.2011.09.039.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.