Ectopic molar removal via retromandibular approach

Ectopic teeth are commonly present in unusual positions or locations within the dentoalveolar structures. Rarely, ectopic teeth may present in more distant locations within the maxillofacial region, such as the maxillary sinus, mandibular condyle and mandibular coronoid process. Given the condition's rarity, the aetiology, clinical presentation and optimal management of distantly located ectopic teeth remain poorly defined. We present a patient with an ectopic molar in the left mandibular subcondylar region associated with recurring swelling and pain. Imaging revealed associated pericoronal radiolucency and surrounding cortical bone expansion of the mandibular ramus. The patient was treated surgically with removal of the ectopic tooth and pericoronal lesion via a retromandibular transparotid approach, with the resolution of the patient's recurring symptoms. In the postoperative period, the patient developed a presumed salivary leak at the incision site that resolved with conservative management. This case highlights the utility of an extraoral approach in the management of an ectopic molar located in the mandibular subcondylar region.