Dimitrakopoulos Ioannis, Papadaki Maria
Aristotle University of Thessaloniki, Department of Oral and Maxillofacial Surgery, General Hospital G. Papanikolaou, Thessaloniki, Greece.
Quintessence Int. 2007 Jul-Aug;38(7):607-10.
The case of a maxillary third molar displaced into the infratemporal fossa, with difficulty in localization due to the synchronous creation of oroantral communication, is described in this article. The patient was referred to the oral and maxillofacial department and underwent successful surgical treatment through an intraoral access. The causes of tooth displacement into the infratemporal fossa, the aid of a computerized tomography (CT) scan in tooth localization, and the difficulty in treating this complication, particularly when the tooth migrates toward the base of the skull, are emphasized. Prevention of maxillary third molar displacement into the infratemporal fossa predominates over removal and is achieved by adequate flap design, correct extraction technique, and a distal retractor during surgical extraction. In the case of displacement, no effort to retrieve the tooth is recommended because of the risk of hemorrhage, neurologic injury, and further displacement of the tooth. The patient should be treated with antibiotics and referred to an oral and maxillofacial department.
本文描述了一例上颌第三磨牙移位至颞下窝的病例,由于同时形成口腔上颌窦交通,导致定位困难。患者被转诊至口腔颌面外科,通过口内入路接受了成功的手术治疗。文中强调了牙齿移位至颞下窝的原因、计算机断层扫描(CT)在牙齿定位中的辅助作用,以及治疗这种并发症的困难,尤其是当牙齿向颅底迁移时。预防上颌第三磨牙移位至颞下窝比拔除更为重要,可通过适当的瓣设计、正确的拔牙技术以及手术拔牙时使用远中牵开器来实现。在发生移位的情况下,由于存在出血、神经损伤和牙齿进一步移位的风险,不建议尝试取出牙齿。应给予患者抗生素治疗,并转诊至口腔颌面外科。