Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, Seville, Spain.
Med Oral Patol Oral Cir Bucal. 2012 Nov 1;17(6):e1013-7. doi: 10.4317/medoral.17864.
To evaluate the etiopathogenesis, clinical features, therapeutic options, and surgical approaches for removal of ectopic third molars in the mandibular condyle.
MEDLINE search of articles published on ectopic third molars in the mandibular condyle from 1980 to 2011. 14 well-documented clinical cases from the literature were evaluated together with a new clinical case provided by the authors, representing a sample of 15 patients.
We found a mean age at diagnosis of 48.6 years and a higher prevalence in women. In 14 patients, associated radiolucent lesions were diagnosed on radiographic studies and confirmed histopathologically as odontogenic cysts. Clinical symptoms were pain and swelling in the jaw or preauricular region, trismus, difficulty chewing, cutaneous fistula and temporomandibular joint dysfunction. Treatment included conservative management in one case and in the other cases, surgical removal by intra- or extraoral approaches, the latter being the most common approach carried out. In most reported cases, serious complications were not outlined.
The etiopathogenic theory involving odontogenic cysts in the displacement of third molars to the mandibular condyle seems to be the most relevant. They must be removed if they cause symptoms or are associated with cystic pathology. The surgical route must be planned according to the location and position of the ectopic third molar, and the possible morbidity associated with surgery.
评估下颌髁突异位第三磨牙的病因、临床特征、治疗选择和手术方法。
对 1980 年至 2011 年发表的关于下颌髁突异位第三磨牙的文献进行 MEDLINE 搜索。对文献中的 14 例有充分记录的临床病例进行评估，并结合作者提供的新临床病例，共代表 15 例患者。
我们发现诊断时的平均年龄为 48.6 岁，女性患病率较高。在 14 例患者中，影像学研究诊断出相关的透亮病变，并经组织病理学证实为牙源性囊肿。临床症状为颌骨或耳前区域疼痛和肿胀、张口受限、咀嚼困难、皮肤瘘管和颞下颌关节功能障碍。治疗包括 1 例保守治疗，另 13 例采用口腔内或口腔外手术切除，后者是最常见的手术方法。在大多数报道的病例中，没有出现严重的并发症。
涉及牙源性囊肿导致第三磨牙移位至下颌髁突的病因学理论似乎最为相关。如果它们引起症状或与囊性病变相关，就必须切除。手术途径必须根据异位第三磨牙的位置和位置以及与手术相关的可能发病率来规划。
