Displacement of maxillary third molar in the infra-temporal fossa

ABSTRACT

Removal of an impacted maxillary third molar is a simple and easy procedure for an Oral and Maxillofacial Surgeon. Nevertheless, complications are possible and include infection, facial swelling, trismus, wound dehiscence, root fracture or even orosinusal fistula. Iatrogenic displacement into the infratemporal fossa is frequently mentioned but rarely reported. This anatomical fossa includes several important structures such as the internal maxillary artery, the venous pterygoid plexus, the sphenopallatinun nerve, the coronoid process of the mandible and the pterygoid muscles. Recommended treatment includes immediate surgical removal if possible or initial observation and secondary removal, as necessary, because of infection, limited mandibular motion, inability to extract the tooth, or the patient's psychologic unease. Sometimes, the displaced tooth may spontaneously migrate inferiorly and becomes accessible intraorally. A 24 year old male patient presenting with pain and swelling in the left third molar region. History, examination and x-rays confirmed a displaced third molar was present in the infratemporal fossa. The molar was displaced during extraction by a dental practitioner. The tooth was recovered successfully