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Displacement of Lower Third Molar into the Parapharyngeal Space during Extraction Leah Finan Ahmed Jebril Anand Kumar Dilip Srinivasan Dental Update 2024 47:4, 707-709.
Authors
LeahFinan
BDentSc, MFD RCSI
Dental Core Trainee, Queen's Medical Centre, Nottingham University Hospitals NHS Trust
Lingual displacement of lower third molar teeth is a well-recognized complication of extraction. The purpose of this article is to report the case of a displaced lower third molar tooth into the parapharyngeal space during extraction. A 44-year-old man was referred to the Oral and Maxillofacial Department by his dentist immediately after the event. The case was managed intra-orally under general anaesthetic. Clinicians must be aware of the possibility of lower third molars being displaced during extraction. This article outlines how clinicians should plan the procedure appropriately, take steps to prevent displacements, and how to manage the situation should it arise.
CPD/Clinical Relevance: Displacement is a risk associated with extraction of lower third molar teeth. This risk can be minimized with proper planning and careful execution of the extraction. It is important that the clinician knows this and how to deal with a displaced tooth in practice.
Article
Lingual displacement of lower third molar teeth, although rare, is a well-recognized complication of extraction.1,2 The most common sites for lower third molar tooth displacement are the sublingual, submandibular and pterygomandibular spaces.3,4 Displacement typically occurs in a lingual direction due to the thinness or absence of the inner cortical bone, as well as application of uncontrolled or excessive force, excessive manipulation, improper surgical planning, or poor clinical and/or radiological assessment.5,6
A 44-year-old man was referred to the Emergency Department of Queen's Medical Centre, Nottingham in June 2017 following a failed extraction by his General Dental Practitioner (GDP). During the surgical extraction of the lower left third molar (LL8), the patient's tooth was displaced lingually while being elevated. The GDP could not locate the molar tooth lingually and so contacted the maxillofacial team. The patient was brought immediately to the hospital. On examination, the extraction socket of the LL8 was open but no tooth fragment was visible or palpable.
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