Displaced Root of 3rd Maxillary Molar Tooth into Infratemporal Fossa- Role of 3D CT Scan

Abstract

The displaced molar tooth is an unexpected and uncommon intraoperative complication of tooth extraction. Its prompt and early identification and management is crucial, as this may reduce the patient morbidity. Orthopantomogram (OPG) has limitations because of extensive anatomical superimposition of various structures. A 36-year-old female patient was referred for Computed Tomography (CT) of maxillofacial region with 3D CT scan for severe pain and swelling in right cheek region with inability to open mouth for 4 days following the dental intervention in outside dental clinic. CT scan of maxillofacial region showed bony defect in the right 3rd maxillary alveolus with multiple small bony fragments. Small fragment of molar tooth was displaced into the right infratemporal fossa and was impinging on right lateral pterygoid muscle with surrounding ill-defined soft tissue infiltrates in right retroantral fat. CT Face with 3D reconstruction helps in accurate localisation and gives appropriate anatomical detail in case of displaced molar tooth into infratemporal fossa. Thus, a detailed radiological investigation and documenting the relations of the displaced tooth or fragment with adjacent structures provides crucial information for proper surgical planning and avoiding possible complications.