Inferolateral Displacement of a Maxillary Third Molar Along the Buccal Fat Pad: A Case Report and Anatomical Note

Iatrogenic displacement of maxillary third molars is an uncommon complication, usually reported in the maxillary sinus or deep posterior spaces. Buccal displacement along the buccal fat pad is rare and may be overlooked. We report the case of a 13-year-old female patient referred after attempted extraction of a maxillary right third molar germ under local anesthesia, resulting in inferolateral displacement. Cone-beam computed tomography localized the tooth in a superficial buccal position, outside the maxillary sinus, infratemporal fossa, pterygopalatine fossa, and parapharyngeal space. Clinical palpation and intraoperative findings suggested migration along the buccal fat pad, close to the buccinator region. The tooth was retrieved under local anesthesia through a limited intraoral buccal approach, with uneventful healing. This case highlights an unusual displacement pathway and emphasizes careful preoperative assessment, controlled surgical exposure, and avoidance of blind force during maxillary third molar germectomy.