Management of iatrogenic displacement of maxillary third molar into pterygomandibular space: case report

Abstract

Third molar surgery is the most common minor oral surgical procedure performed in dental clinics. Displacement of maxillary third molar tooth into adjacent spaces such as infratemporal fossa, maxillary sinus has been reported earlier. We present an unusual case of iatrogenic displacement of maxillary third molar into pterygomandibular space. A 24 year old dental undergraduate reported to Department of Oral surgery with complaints of trismus and swelling in the check region after unsuccessful attempt at extraction of maxillary right third molar tooth. Computed tomography scan localized the tooth in the pterygomandibular space. A surgical removal of the displaced tooth was performed under general anesthesia. Displaced tooth was approached by an intraoral vertical incision along the anterior border of ramus of mandible. Correlating with computed tomography scan, tooth was located and removed followed by suturing of the surgical site. A good knowledge of the operating area and adjoining spaces is essential to avoid iatrogenic damage to tissues during minor oral surgery procedures. Adequate exposure and appropriate instrumentation during surgery can prevent undue complications and ensure quality patient care.