Ectopic molar removal via retromandibular approach

Area of Science:

• Dentistry
• Oral and Maxillofacial Surgery
• Radiology

Background:

• Ectopic teeth typically occur in unusual dentoalveolar positions.
• Rarely, ectopic teeth are found in distant maxillofacial locations like the maxillary sinus or mandibular condyle.
• The etiology, presentation, and management of these distant ectopic teeth are poorly defined due to their rarity.

Purpose of the Study:

• To present a case of a distantly located ectopic molar.
• To describe the clinical presentation and diagnostic imaging findings.
• To evaluate the surgical management and outcome of an ectopic molar in the mandibular subcondylar region.

Main Methods:

• A patient presented with a left mandibular subcondylar ectopic molar causing recurrent swelling and pain.
• Imaging revealed a pericoronal radiolucency and mandibular ramus cortical expansion.
• Surgical excision of the ectopic tooth and lesion was performed using a retromandibular transparotid approach.

Main Results:

• The surgical removal of the ectopic molar and associated lesion led to complete resolution of the patient's symptoms.
• A postoperative salivary leak occurred but resolved with conservative management.
• The extraoral approach proved effective for managing this subcondylar ectopic molar.

Conclusions:

• Distantly located ectopic teeth, such as in the mandibular subcondylar region, are rare but can cause significant symptoms.
• An extraoral retromandibular transparotid approach is a viable surgical option for managing ectopic molars in this location.
• Prompt diagnosis and surgical intervention can lead to successful symptom resolution.