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下颌第三磨牙意外移位至下颌下间隙后的取出:两例系列报道

Retrieval of mandibular third molar tooth accidentally displaced in submandibular space: Series of two cases.

作者信息

Solanki Ravinder, Khangwal Monika, Kumar Davender, Goel Mahesh

机构信息

Department of Oral and Maxillofacial Surgery, Postgraduate Institute of Dental Sciences, Rohtak, Haryana, India.

Department of Conservative Dentistry, Postgraduate Institute of Dental Sciences, Rohtak, Haryana, India.

出版信息

Indian J Dent. 2016 Apr-Jun;7(2):105-8. doi: 10.4103/0975-962X.184653.

Abstract

Displacement of tooth or root in submandibular or parapharyngeal spaces is one of the serious complications while extracting mandibular third molar by the general practitioners. Possibilities enhance in cases with extremely thin lingual plates. Moreover, there are no posterior fascial borders limiting the sublingual and submandibular spaces. In addition, no fascial border separates these spaces from the inferior parapharyngeal space. Thus, there is free communication between these spaces and tooth easily may dislodge into further spaces and lead to serious complications ahead. Patients may represent with pain and swelling of the submandibular region and sometimes the limitation in mouth opening when the patient had undergone an unsuccessful surgical procedure and third molar displacement into submandibular space. Two cases of such complications are presented ahead. On clinical examination, submandibular area on the left side of the mandible was tender on palpation. Panoramic radiographs elicited presence of a radiopaque mass similar to that of a tooth root. The computed tomography (CT) scan confirmed the presence of a high-density area in the submandibular region. Orthopantomography and cone beam CT in another patient revealed the displaced third molar in submandibular space. Patients were planned to retrieve the tooth under local anesthesia and the postoperative course was uneventful.

摘要

下颌第三磨牙拔除过程中,牙齿或牙根移位至下颌下间隙或咽旁间隙是全科医生面临的严重并发症之一。舌侧骨板极薄时,这种可能性会增加。此外,没有后筋膜边界限制舌下间隙和下颌下间隙。此外,也没有筋膜边界将这些间隙与咽旁下间隙分隔开。因此,这些间隙之间存在自由交通,牙齿很容易移位到其他间隙,进而导致严重并发症。当患者手术失败且第三磨牙移位至下颌下间隙时,患者可能会出现下颌下区疼痛、肿胀,有时还会出现张口受限。以下介绍两例此类并发症。临床检查时,下颌骨左侧下颌下区触诊压痛。全景片显示存在一个类似于牙根的不透光团块。计算机断层扫描(CT)证实下颌下区存在高密度区。另一例患者的曲面体层摄影和锥形束CT显示下颌下间隙内有移位的第三磨牙。计划在局部麻醉下取出牙齿,术后过程顺利。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16ac/4934085/f08238d9adc3/IJDENT-7-105-g001.jpg

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