Delavaquerie-Lesnes Sarah, Brenet Esteban, Derruau Stéphane, Clement Thomas, Mauprivez Cédric
Medecine bucco-dentaire, Reims university hospital, 45 rue Cognacq Jay, 51100, Reims, France.
ORL service, Reims university hospital, rue du General Koenig , 51100, Reims, France.
Oral Maxillofac Surg. 2025 Sep 2;29(1):148. doi: 10.1007/s10006-025-01444-1.
Accidental displacement of impacted and non-erupted upper third molars into the maxillary sinus, buccal space, infratemporal fossa, and lateral pharyngeal space is uncommon. Herein, we present an unusual case of parapharyngeal cellulitis secondary to iatrogenic displacement of the right third molar. Clinical history, physical examination, and imaging assessment are essential in the evaluation of teeth projected into adjacent anatomic spaces. Panoramic radiography, the first-line imaging modality used to help screen and visualize the abnormal position of the tooth, is not sufficient. Additional investigation is required to depict and localize the displaced tooth, assess potential complications, and guide removal. We suggest preoperative MRI to minimize perioperative risks, with a special focus on the most adjacent vulnerable structures, and intraoperative C-arm fluoroscopy imaging to contribute to safe minimally invasive surgery.
阻生和未萌出的上颌第三磨牙意外移位至上颌窦、颊间隙、颞下窝和咽旁间隙的情况并不常见。在此,我们报告一例因右第三磨牙医源性移位继发咽旁蜂窝织炎的罕见病例。临床病史、体格检查和影像学评估对于评估突入相邻解剖间隙的牙齿至关重要。全景X线摄影作为用于帮助筛查和可视化牙齿异常位置的一线成像方式并不足够。需要进一步检查以描绘和定位移位的牙齿、评估潜在并发症并指导取出。我们建议术前行MRI以将围手术期风险降至最低,特别关注最邻近的易损结构,并在术中使用C形臂荧光透视成像以助力安全的微创手术。