Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli," Naples.
Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Policlinico G. Martino, Messina, Italy.
J Craniofac Surg. 2021;32(5):1890-1893. doi: 10.1097/SCS.0000000000007457.
Ectopic lower third molar is an uncommon condition, and its etiology remains unclear. The main approach used for its surgical removal is the intraoral one, but there are cases in which this may not be the best option. When the lower third molar is located below the lower alveolar canal or when it is close to the lower edge of the jaw, the most recommended approach is the extraoral one. The critical issues related to the extraoral approach are the possibility of damaging anatomical structures such as marginal mandibular branch of the facial nerve (craniofacial nerve VII), facial artery and vein, and submental artery. This complication can occur during incision and dissection of the superficial layers or during osteotomy with rotating instruments.This paper reports a case of extraction of ectopic lower third molar using a minimally invasive extraoral approach combined with piezoelectric surgery in order to prevent intraoperative injury of anatomical structures.
异位第三磨牙是一种不常见的情况，其病因尚不清楚。其手术切除的主要方法是经口内，但有些情况下，这可能不是最佳选择。当第三磨牙位于下牙槽管下方或靠近下颌下缘时，最推荐的方法是经口外。经口外入路相关的关键问题是损伤解剖结构的可能性，如面神经下颌缘支（颅面神经 VII）、面动脉和静脉以及颏下动脉。这种并发症可能发生在浅层切开和剥离过程中，也可能发生在旋转器械截骨过程中。本文报告了一例采用微创经口外入路联合超声骨刀手术的异位第三磨牙拔除病例，以防止术中解剖结构损伤。
