Immediate Removal of a Dislocated Dental Fragment from the Submandibular Space during Extraction of the Lower Third Molar: Case Report and Literature Review
DOI:
https://doi.org/10.17921/2447-8938.2019v21n5p459-463Resumo
Abstract
This paper aims to report a case of radicular displacement to the submandibular space and to review the literature seeking reports of dental displacements / fragments published in the period from 2007 to 2017 in PubMed evidencing risk factors, prevention and forms of treatment. In this article a case of displacement of dental fragments to the submandibular space with immediate removal is reported. The third molar or its roots displacement into facial spaces is a rare situation. The preoperative surgical planning is fundamental to avoid this type of complication. The association of (1) good surgical planning, (2) surgical technique utilization and adequate instruments, and (3) the surgeon experience are determining factors to avoid the occurrence of this complication.
Keywords: Molar, Third. Surgery, Oral. Intraoperative Complications.
Resumo
A extração de terceiros molares é o procedimento cirúrgico mais frequente nos consultórios odontológicos. Como qualquer cirurgia, existe a possibilidade de complicações trans e pós-operatórias. O deslocamento desses dentes ou fragmento dentário para espaços faciais é raro, com frequência extremamente baixa. Este trabalho tem como objetivo relatar um caso de deslocamento radicular para o espaço submandibular e revisar a literatura buscando relatos de deslocamentos dentários/fragmentos publicados no período de 2007 a 2017 no Pubmed evidenciando fatores de risco, prevenção e formas de tratamento. Nesse artigo nós relatamos um caso de deslocamento de um fragmento radicular para o espaço submandibular, sendo este removido imediatamente. O deslocamento do terceiro molar ou de fragmentos radiculares para os espaços faciais é raro. A avaliação pré-operatória é fundamental para evitar esse tipo de complicação. A associação entre (1) planejamento cirúrgico correto, (2) utilização de técnica e materiais corretos e (3) experiência do profissional, são fatores determinantes para evitar esse tipo de complicação.
Palavras-chave: Dente Serotino. Cirurgia Bucal. Complicações Intraoperatórias.
Referências
Zhao S, Huang Z, Geng T, Huang L. Intraoral management of iatrogenically displaced lower third molar roots in the sublingual space: a report of 2 cases. Int J Clin Exp Med 2015; 8:19591-5.
Oze R, Khangwal M, Kumar D, Goel M. Retrieval of mandibular third molar tooth accidentally displaced in submandibular space: Series of two cases. Indian J Dent 2016;7(2):105-8. doi: 10.4103/0975-962X.184653.
Sverzut CE, Trivellato AE, Sverzut AT, de Matos FP, Kato RB. Removal of a maxillary third molar accidentally displaced into the infratemporal fossa via intraoral approach under local anesthesia: report of a case. J Oral Maxillofac Surg 2009;6:1316-20. doi: 10.1016/j.joms.2008.09.018.
Shahakbari R, Mortazavi H, Eshghpour M. First report of acidental displacement of mandibular third molar into infratemporal space. J Oral Maxillofac Surg 2011;69:1301-3. doi: 10.1016/j.joms.2010.06.215
Silveira RJ, Garcia RR, Botelho TL, Franco A, Silva RF. Accidental displacement of third molar into the sublingual space: a case report. J Oral Maxillofac Res 2014; 5:e5.
Selvi F, Cakarer S, Keskin C, Ozyuvaci H. Delayed removal of a maxillary third molar accidentally displaced into the infratemporal fossa. J Craniofac Surg 2011;22(4):1391-3. doi: 10.5037/jomr.2014.5305
Berton F, Stacchi C, Lombardi T, Di Lenarda R. Removal of a maxillary third molar accidentally displaced into the maxillary sinus: presurgical and surgical management. Minerva Stomatol 2016;65(2):122-4.
Jolly SS, Rattan V, Rai SK. Intraoral management of displaced root into submandibular space under local anaesthesia: a case report and review of literature. Saudi Dent J 2014;26(4):181-4. doi: 10.1016/j.sdentj.2014.05.004.
Huang IY, Wu CW, Worthington P. The Displaced Lower Third Molar: A Literature Review and Suggestions for Management. J Oral Maxillofac Surg 2007;65:1186-90. doi:10.1016/j.joms.2006.11.031.
Solanki R, Khangwal M, Kumar D, Goel M. Retrieval of mandibular third molar accidentally displaced in submandibular space: Series of two cases. Indian J Dent 2016;7(2):105-8. doi: 10.4103/0975-962X.184653
Kamburoglu K, Kursun S, Oztas B. Submandibular displacement of a mandibular third molar root during extraction: a case report. Cases J 2010;3:8. doi: 10.1186/1757-1626-3-8.
Kose I, Koparal M, Güneş N, Atalay Y, Yaman F, Atilgan S, et al. Displaced lower third molar tooth into the submandibular space: Two case reports. J Nat Sci Biol Med 2014;5(2):482-4. doi: 10.4103/0976-9668.136274.
Aznar- Arasa L, Figueiredo R, Gay-Escoda C. Iatrogenic displacement of lower third molar roots into the sublingual space: report of 6 cases. J Oral Maxillofac Surg 2012;70:e107-15. doi: 10.1016/j.joms.2011.09.039.
Polo TOB, Momesso GAC, de Lima VN, Faverani LP, Souza FÁ, Garcia-Junior IR. Inappropriate management after accidental displacement of upper third molar to the infratemporal fossa may disrupt its subsequent removal. J Craniofac Surg 2017;28(3):298-9. doi: 10.1097/SCS.0000000000003553.
Gay-Escoda C, Berini-Aytés L, Piñera-Penalva M. Accidental displacement of a lower third molar: report of a case in the lateral cervical position. Oral Surg Oral Med Oral Pathol 1993;76:159-60.
Medeiros N, Gaffrée G. Accidental displacement of inferior third molar into the lateral pharyngeal space: case report. J Oral Maxillofac Surg 2008; 66:578-80. doi: 10.1016/j.joms.2005.10.042
Bui CH, Seldin EB, Dodson TB. Types, frequencies, and risk factors for complications after third molar extraction. J Oral Maxillofac Surg 2003; 61:1379-89. doi: 10.1016/S0278.2391(03)00836-X.
Brauer HU, Dent M. Unusual complications associated with third molar surgery: a systematic review. Quintessence Int 2009; 40:565-72.
Emes Y, Öncu B, Aybar B, Al-Badri N, Iᶊsever H, Atalay B, et al. Measurement of the lingual position of the lower third molar roots using cone-beam computed tomography. J Oral Maxillofac Surg 2015; 73:13-7. doi: 10.1016/j.joms.2014.06.460.
Xavier CB, Gonçalves FR, Batista SHB, Veras Filho RO, Vogt BF. Spontaneous migration of third molar following displacement to pterygomandibular fossa. J Oral Maxillofac Surg 2011; 69:1004-7. doi: 10.1016/j.joms.2010.05.052.
Kamburoglu K, Kursun S, Oztas B. Submandibular displacement of a mandibular third molar root during extraction: a case report. Cases J 2010, 3:8. doi: 10.1186/1757-1626-3-8
Ohba S, Nakatani Y, Kakehashi H, Asahina I. The migration pathway of an extracted maxillary third molar into the buccal fat pad. Odontology 2014; 102:339-42. doi: 10.1007/s10266-013-0120-7.
Kocaelli H, Balcioglu HA, Erdem TL. Displacement of a maxillary third molar into the buccal space: anatomical implications apropos of a case. Int J Oral Maxillofac Surg 2011; 40(6):650-3. doi: 10.1016/j.ijom.2010.11.021.
Huang YC, Chen CM, Chuang FH. Caldwell-Luc procedure for retrieval of displaced root in the maxillary sinus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112:59-63. doi: 10.1016/j.tripleo.2011.05.018
Iwai T, Matsui Y, Hirota M, Tohnai I. Endoscopic removal of a maxillary third molar displaced into the maxillary sinus via the socket. J Craniofac Surg 2012; 23(4):e295-6. doi: 10.1097/SCS.0b013e318252f1cf.
Bozkurt P, Erdem E. Management of upper and lower molars that are displaced into the neighbouring spaces. Br J Oral Maxillofac Surg 2017; 55(9):e49-52. doi: 10.1016/j.bjoms.2017.07.001.
Suer BT,Kocyigit ID, Ortakoglu K. Iatrogenic Displacement of impacted mandibular third molar into the pterygomandibular space: a case report. Oral Health Dent Manag 2014;12(2):179-92.
Guo Y, Xu DD, Lv K, Wan QL, Li ZB, Li Z. Use of Computer-Assisted Navigation in the Retrieval of Accidentally Displaced Third Molars. J Oral Maxillofac Surg 2016; 74:889-4. doi: 10.1016/j.joms.2015.12.015
Özalp B, Kuvati SV, Emekli U. Conservative treatment of displaced mandibular third molar. J Craniofac Surg 2010; 21:1314-5.
Lee D, Ishii S, Ykushiji N. Displacement of Maxillary Third Molar Into the Lateral Pharyngeal Space. J Oral Maxillofac Surg 2013;71: 1653-7. doi: 10.1016/j.joms.2013.05.018.
Gómez-Oliveira G, Arribas-García I, Alvarez-Flores M, Gregorie-Ferriol J, Martínez-Gimeno C. Delayed removal of a maxillary third molar from the infratemporal fossa. Med Oral Patol Oral Cir Bucal 2010; 15(3):e509-11. doi: 10.4317/medoral.15.e509
Battisti A, Priore P, Giovannetti F, Barbera G, D'Alessandro F, Valentini V. Sare complication in third maxillary molar extraction: dislocation in infratemporal fossa. J Craniofac Surg 2017;28(7):1784-5. doi: 10.1097/SCS.0000000000003628.
Sencimen M, Gülses A, Secer S, Zerener T, Özarslantürk S. Delayed retrieval of a displaced maxillary third molar from infratemporal space via trans-sinusoidal approach: a case report and the review of the literature. Oral Maxillofac Surg 2017;21(1):1-6.
Ozer N, Uçem F, Saruhanoğlu A, Yilmaz S, Tanyeri H. Removal of a Maxillary Third Molar Displaced into Pterygopalatine Fossa via Intraoral Approach. Case Rep Dent 2013;2013:392148.
Campbell A, Costello BJ. Retrieval of a displaced third molar using navigation and active image guidance. J Oral Maxillofac Surg 2010;68:480-5.
SA, Barros VM, Salata LA, Rosa AL, Soares UN. Complications in exodontia –Accidental dislodgement to adjacent anatomical areas. Braz Dent J 1992;3:103-12
Tumuluri V, Punnia-Moorthy A. Displacement of a mandibular third molar root fragment into the pterygomandibular space. Aust Den J 2992;47:(1):68-71.
Ohshima A, Ariji Y, Goto M, Izumi M, Naitoh M, Kurita K, Shimozato K, Ariji E. Anatomical considerations for the spread of odontogenic infection originating from the pericoronitis of impacted mandibular third molar: Computed tomographic analyses. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:589-97.
Tolstunov L, Brickeen M, Kamaninc V, Susarla SM, Selvi F. Is the angulation of mandibular third molars associated with the thickness of lingual bone?. Br J Oral Maxillofac 2016;54(8):914-9. doi: 10.1016/j.bjoms.2016.06.005.
Yeh CJ. A simple retrieval technique for accidentally displaced mandibular third molars. J Oral Maxillofac Surg 2002;60:836-7.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Os autores devem ceder expressamente os direitos autorais à Kroton Educacional, sendo que a cessão passa a valer a partir da submissão do artigo, ou trabalho em forma similar, ao sistema eletrônico de publicações institucionais. A revista se reserva o direito de efetuar, nos originais, alterações de ordem normativa, ortográfica e gramatical, com vistas a manter o padrão culto da língua, respeitando, porém, o estilo dos autores. As provas finais serão enviadas aos autores. Os trabalhos publicados passam a ser propriedade da Kroton Educacional, ficando sua reimpressão total ou parcial, sujeita à autorização expressa da direção da Kroton Educacional. O conteúdo relatado e as opiniões emitidas pelos autores dos artigos são de sua exclusiva responsabilidade.
