The Story of a Missing Tooth: A Case Report

Abstract

The displacement of an impacted third molar, either a root fragment, the crown, or the entire tooth is a complication that rarely occurs during exodontia. Although the complication is well known, reported cases in the dental literature are sparse. We report here an unusual accidental displacement of a mandibular third molar crown into the parapharyngeal space in an adult male patient. As a result if a complication does occur during third molar extraction such in our case, dentists should immediately refer the patient to an oral and maxillofacial surgeon and should not try to remove the displaced root without proper assurance. This is imperative for being able to evaluate the condition of the tooth preoperatively, select adequate instruments and technique, and take good care during extraction and prevent the risk of hemorrhage, neurologic injury, and further displacement of the tooth. Localization with images and proper surgical methods are the keys to retrieving the displaced fragment successfully. In combination with clinical examination, conventional and advanced radiographic techniques were utilized in order to locate the crown for retrieval surgery. This report not only describes the location, but also the surgical removal of an accidentally displaced mandibular third molar displaced in the parapharayngeal space, two weeks after first attempt of extraction.