Management strategies for unanticipated remnants following tooth extraction: A case report

Tooth extraction is a common oral surgical procedure, yet rare complications such as retained tooth fragments may occur. These remnants - including crown fragments, root tips, or other materials - can delay healing, provoke infection, and impair oral function, posing challenges for clinicians. Because fragments may migrate extra-socket and be masked by fibrotic tissue, routine examination can be falsely negative and diagnosis delayed. This case report clarifies when and why early CBCT is warranted to localize retained crown fragments and demonstrates a micro-incision retrieval strategy that minimizes morbidity and supports timely recovery.

A 27-year-old Chinese female presented with progressive buccal swelling and abnormal sensations 3 months after extraction of the mandibular right third molar (tooth 48). Cone-beam computed tomography (CBCT) identified 2 retained crown fragments.

Retained crown fragments were diagnosed on CBCT and correlated with the patient's symptoms.

The fragments were surgically removed through a small distobuccal incision adjacent to tooth 47 under local anesthesia, after which symptoms resolved.

Postoperative recovery was uneventful. The patient reported complete resolution of symptoms and improved oral function, with no complications during follow-up.

This case highlights the potential for unanticipated remnants after tooth extraction and the need for prompt recognition. Early radiographic assessment - particularly CBCT when indicated - followed by timely surgical removal can prevent long-term complications and support optimal recovery.