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Extra-oral approach to lower third molar: a rare surgical indication
Giorgio Novelli1, Andrea Filippi2,3, Alberto Bozzetti2
1Unit of Maxillofacial Surgery, ASST Monza, San Gerardo Hospital, University of Milano-Bicocca, Monza, Monza-Brianza, Italy - g.novelli@asst-monza.it.
Minerva Dental and Oral Science
|October 12, 2021
Summary
The extra-oral surgical approach is a viable option for treating rare ectopic impacted lower wisdom teeth. Careful patient selection and surgeon expertise are crucial for successful outcomes.
Area of Science:
- Oral Surgery
- Maxillofacial Surgery
Background:
- Impacted lower third molars (wisdom teeth) are common, with intra-oral surgery as the standard approach.
- Ectopic impacted lower third molars, located in mandibular basal bone, are rare and pose unique surgical challenges.
- Nerve injury (lingual and inferior alveolar) is a known complication of lower third molar extraction.
Purpose of the Study:
- To present cases of ectopic impacted lower third molars.
- To discuss the suitability of an extra-oral surgical approach for these rare conditions.
- To highlight the importance of patient counseling and surgical expertise.
Main Methods:
- Retrospective case series presentation from a Maxillofacial Surgery department.
- Review of three cases involving ectopic impacted lower third molars.
- Surgical management and outcomes analysis.
Main Results:
- Two patients refused treatment due to perceived risks.
- One patient successfully underwent surgical avulsion via an extra-oral transcervical approach.
- No early or late complications were reported in the treated patient.
Conclusions:
- An extra-oral surgical approach should be considered for select cases of ectopic impacted lower third molars.
- Accurate preoperative patient information regarding risks is essential.
- This complex procedure requires highly skilled and experienced surgeons.
