MR imaging evaluation of accidental third molar displacement into parapharyngeal space: a case report

Accidental displacement of impacted and non-erupted upper third molars into the maxillary sinus, buccal space, infratemporal fossa, and lateral pharyngeal space is uncommon. Herein, we present an unusual case of parapharyngeal cellulitis secondary to iatrogenic displacement of the right third molar. Clinical history, physical examination, and imaging assessment are essential in the evaluation of teeth projected into adjacent anatomic spaces. Panoramic radiography, the first-line imaging modality used to help screen and visualize the abnormal position of the tooth, is not sufficient. Additional investigation is required to depict and localize the displaced tooth, assess potential complications, and guide removal. We suggest preoperative MRI to minimize perioperative risks, with a special focus on the most adjacent vulnerable structures, and intraoperative C-arm fluoroscopy imaging to contribute to safe minimally invasive surgery.