Displacement of lower third molar into parapharyngeal space. Case report

Surgery of lower third molar may be accompanied by many complications. One of these complications which has been documented in literature is its displacement lingually. In this case report, the tooth was displaced into an area between submandibular salivary gland, root of the tongue and upper portion of pharynx. The incidence happened during trial of third molar extraction by general practitioner dentist. The cause of such complication may be heavy force application during closed extraction using elevator. Patient presented with trismus, swelling and disphagia. Under general anesthesia trial of removal by intraoral approach done but failed. Through extraoral approach the tooth and a piece of fractured bone removed from mentioned space. Antibiotic therapy and palliative therapy gave positive effect after48 hours from surgery and complete subsiding of signs and symptoms after 10 days from surgery. Conclusion: for partially and completely impacted third molar removal the best option is open surgery and controlled force. This tooth better to be removed by oral surgeon to have ability to control possible complications.