Impacted maxillary third molar displaced to the infratemporal space: a critical review and case report

The aim of the present study was to use the scientific evidence found in a critical literature review as a basis to discuss the displacement of maxillary third molars to the infratemporal fossa in terms of anatomical and demographic characteristics and the treatment protocols used. In addition, this article reports a new clinical case of third molar displacement in a 19-year-old man. For the literature review, the Cochrane, Medline, Lilacs, and BBO databases were searched for relevant key words, and the selected articles were classified in accordance with their level of evidence according to the Oxford Centre for Evidence-Based Medicine criteria. Twenty-two articles were found, but only 13 were considered relevant and met the criteria for inclusion in this review. All of the articles were classified as Level 6b for scientific evidence (case reports). The maxillary left third molar was more commonly displaced to the infratemporal fossa (69.23%) than was the right third molar. Most of the molars exhibited complete root formation (53.84%), were multirooted (69.23%), and had fused roots (53.84%). During the procedures for removal of the displaced molars, either general or local anesthetic agents were used. Surgical access for molar removal was almost always intraoral, and no permanent postoperative complications were recorded. The time from tooth displacement until attempted surgical removal ranged from immediately to 24 years after the displacement. Both general dentists and oral and maxillofacial surgeons were responsible for the displacements.