A Wassouf1, G Eyrich, R Lebeda, K W Grätz. 1. Department of Cranio-Maxillofacial Surgery at University Hospital of Zurich, Switzerland. wassoufaa@yahoo.com
Abstract
INTRODUCTION: Migration of dislocated lower third molar into the condylar region is quite rare. Attention should be taken to avoid condyle fracture. METHODS: 49-year-old patient had an ectopic lower left third molal in the condylar region, suffered from a submandibular and masseter space abscess. Removal of the molar via intraoral approach was chosen avoiding facial nerve branches and unnecessary scar formation. Coronoid process is removed, the tooth is separated and removed. The defect is filled with iliac cancellous bone. The coronoid process was fixed as a cover with a resorbable plate and screws (BIONX). RESULTS: Removal via intraoral approach is possible. Hypesthesia existed postoperatively, became normal later. CONCLUSION: Annual observation is strongly recommended. Intraoral approach is superior to the extraoral approach. Removal of the coronoid process minimizes the masticator forces. Separation of the tooth is essential. Filling the defect with cancellous bone accelerates the healing.
INTRODUCTION: Migration of dislocated lower third molar into the condylar region is quite rare. Attention should be taken to avoid condyle fracture. METHODS: 49-year-old patient had an ectopic lower left third molal in the condylar region, suffered from a submandibular and masseter space abscess. Removal of the molar via intraoral approach was chosen avoiding facial nerve branches and unnecessary scar formation. Coronoid process is removed, the tooth is separated and removed. The defect is filled with iliac cancellous bone. The coronoid process was fixed as a cover with a resorbable plate and screws (BIONX). RESULTS: Removal via intraoral approach is possible. Hypesthesia existed postoperatively, became normal later. CONCLUSION: Annual observation is strongly recommended. Intraoral approach is superior to the extraoral approach. Removal of the coronoid process minimizes the masticator forces. Separation of the tooth is essential. Filling the defect with cancellous bone accelerates the healing.
Authors: Fernando Iglesias-Martin; Pedro Infante-Cossio; Eusebio Torres-Carranza; Victoria-Eugenia Prats-Golczer; Alberto Garcia-Perla-Garcia Journal: Med Oral Patol Oral Cir Bucal Date: 2012-11-01