Persistent Oral Infection Caused by an Iatrogenic Displacement of a Lower Third Molar Root to the Sublingual Space

JOURNAL TITLE: Journal of Contemporary Dentistry

Author
1. João de Jesus Viana Pinheiro
2. Lucas R Pinheiro
3. André LR Ribeiro
4. Antonia TL de Moraes
5. Naama WA Sousa
6. Ana PG Rodrigues Couto
7. Douglas M Guimarães
ISSN
2278-2680
DOI
10.5005/jp-journals-10031-1269
Volume
9
Issue
3
Publishing Year
2019
Pages
4
Author Affiliations
    1. School of Dentistry, University Centre of Para–CESUPA, Belem, Pará Brazil
    1. School of Dentistry, Federal University of Pará (UFPA), Belém, Pará, Brazil
    1. School of Dentistry, Federal University of Pará (UFPA), Belém, Pará, Brazil
    1. School of Dentistry, University Centre of Para–CESUPA, Belem, Pará Brazil
    1. School of Dentistry, University Centre of Para–CESUPA, Belem, Pará Brazil
    1. School of Dentistry, Federal University of Pará (UFPA), Belém, Pará, Brazil
    1. School of Dentistry, Federal University of Pará (UFPA), Belém, Pará, Brazil
  • Article keywords

    Abstract

    Aim and objective: Describe a case of sublingual displacement of a root of the lower third molar, as well as highlight the importance of using appropriate complementary imaging tests and provide the clinician with information on how to prevent and treat this complication. Background: The displacement of the lower third molar is an accidental event that can lead to serious complications, which is usually the cause of inadequate surgical technique. Case description: A 69-year-old man presented pain and trismus due to local infection 1 month after a tooth extraction. After a misdiagnosis of retained root and surgical exploration, a cone-beam computed tomography (CBCT) showed a displaced root into the sublingual tissues. A surgical procedure under local anesthesia was carried out to easily remove the displaced tooth root, which resulted in complete healing of soft tissues and disappearance of signs of local infection. Conclusion: The use of CBCT is essential for the identification and location of the dislocated tooth and the removal of the fragment, as it allows a three-dimensional assessment providing adequate surgical planning which resulted in complete remission of all symptoms. Clinical significance: Few reports have been published to describe this rare complication of dental extractions that support key points for proper management: (1) the use of three-dimensional imaging for proper evaluation and establishment of exact location; (2) careful surgical planning; (3) precise surgery. Successful tooth removal is the main goal of treatment, which usually results in control of associated signs and symptoms.

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