Forgach Gary A, MacLeod Stephen P R
Department of Oral and Maxillofacial Surgery, Loyola University Medical Center, Maywood, Illinois.
Division of Oral and Maxillofacial Surgery and Dental Medicine, Department of Surgery, Loyola University Medical Center, Maywood, Illinois.
Craniomaxillofac Trauma Reconstr. 2018 Mar;11(1):59-64. doi: 10.1055/s-0036-1594275. Epub 2017 Jan 3.
Ectopic molars within the mandibular ramus/condyle unit, although rare, present a unique challenge to the surgeon. Multiple approaches have been described in the literature for their removal. A review of the English literature on the subject of mandibular ectopic molars and their epidemiology, etiology, indications for removal, and surgical techniques was completed. In addition, a case report is presented of an ectopic mandibular molar in the mid-ramus region which was removed via a minimally invasive, intraoral, technique combining the use of endoscopy and piezoelectric surgery. The authors advocate this technique as it offers the following advantages: avoidance of injury to branches of the facial nerve, unaesthetic scars, and sialocele formation; maximization of surgical field visualization with limited dissection; ability for safe sectioning of the tooth with minimal risks to adjacent structures; and precise bone removal, reducing the risk of iatrogenic or postoperative mandible fracture.
下颌升支/髁突单元内的异位磨牙虽然罕见,但给外科医生带来了独特的挑战。文献中描述了多种去除它们的方法。完成了对关于下颌异位磨牙及其流行病学、病因、去除指征和手术技术的英文文献的综述。此外,还报告了一例位于升支中部区域的异位下颌磨牙病例,该病例通过一种结合使用内窥镜和压电手术的微创口内技术得以切除。作者提倡这种技术,因为它具有以下优点:避免对面神经分支造成损伤、避免形成不美观的瘢痕和涎囊肿;通过有限的解剖最大限度地提高手术视野的可视化;能够安全地切割牙齿,对相邻结构的风险最小;以及精确去除骨质,降低医源性或术后下颌骨骨折的风险。