Selvi Firat, Cakarer Sirmahan, Keskin Cengizhan, Ozyuvaci Hakan
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
J Craniofac Surg. 2011 Jul;22(4):1391-3. doi: 10.1097/SCS.0b013e31821cc254.
The removal of an impacted maxillary third molar is an easy procedure for an oral and maxillofacial surgeon. The most commonly seen complications associated with this type of surgery are excessive hemorrhage, infection, pain, swelling, trismus, and root fractures. Although rarely encountered, unexpected complications may also arise during this procedure, such as the displacement of the tooth into an anatomic space. In this article, a case of a maxillary left third molar accidentally displaced into the infratemporal fossa is presented, and the delayed removal of the tooth after 3 weeks from the initial unsuccessful attempt is described, along with the correlating reasons. The role of the radiologic analysis in determining the localization of the tooth, including the routine panoramic radiographs and more importantly the volumetric computed tomographic scans, is stated. The different surgical treatment options are classified, and the potential for morbidity in the surgical removal of the tooth from the infratemporal fossa is presented by ranging the vital anatomic structures running through it.
对于口腔颌面外科医生来说,拔除上颌阻生第三磨牙是一项简单的操作。这类手术最常见的并发症包括出血过多、感染、疼痛、肿胀、牙关紧闭和牙根折断。尽管这种情况很少见,但在此手术过程中也可能出现意外并发症,例如牙齿移位至解剖间隙。本文介绍了一例上颌左侧第三磨牙意外移位至颞下窝的病例,并描述了在初次尝试拔除失败3周后延迟拔除该牙的情况及相关原因。阐述了放射学分析在确定牙齿位置中的作用,包括常规全景X线片,更重要的是容积计算机断层扫描。对不同的手术治疗方案进行了分类,并通过梳理穿过颞下窝的重要解剖结构,介绍了从颞下窝拔除该牙手术中发生并发症的可能性。