Displacement of lower third molar into floor of mouth: a single institutional experience

• Published in: Oral and maxillofacial surgery Vol. 26; no. 3; pp. 447 - 453
• Main Authors: Masui, Masanori, Ibaragi, Soichiro, Takeshita, Yohei, Iwanaga, Joe, Kunisada, Yuki, Sasaki, Akira
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2022; Springer Nature B.V
• Subjects: Dentistry; Hospitals; Infections; Maxillofacial surgery; Medicine; Medicine & Public Health; Mouth; Oral and Maxillofacial Surgery; Original Article; Patients; Pharmaceutical sciences; University graduates; Infection; Wisdom tooth; Ludwig’s angina; Tooth extraction; Lower third molar; Lingual nerve injury
• ISSN: 1865-1569; 1865-1550; 1865-1569
• DOI: 10.1007/s10006-021-01012-3

Purpose
The displacement of the tooth/tooth fragment into the floor of mouth sometimes happens during the lower third molar surgery and the patients are usually referred to oral and maxillofacial surgeons. To date, however, there is no consensus how to manage the displaced tooth due to the lack of available data.
Methods
In this study, we have retrospectively analyzed the management of the displaced lower third molar into the floor of mouth. Our institute experienced seven cases during 2010 to 2020.
Results
Incidence rate of the lingual nerve injury caused by displacement of the lower third molar was 1/7. Six patients out of seven underwent surgical removal of the displaced fragment. The direct approach was used when the fragment was palpable superficially and the fragment was horizontally located away from the lingual plate (2 cases), while when the fragment was not palpable, or was palpable and adjacent to the lingual plate, the lingual mucoperiosteal flap was selected (4 cases).
Conclusion
We conclude that the palpation and preoperative diagnosis with computed tomographic images are significantly important to decide a better and most effective surgical approach.