The displaced lower third molar: a literature review and suggestions for management

Abstract

Purpose: To review the literature associated with displaced lower third molars, to introduce a modified method of retrieval of an accidentally displaced lower third molar tooth or root fragment, and to recommend rational guidelines for management.

Materials and methods: A review of the literature was performed to record the types of displacements, patient's personal data, imaging used, and the surgical approaches with their complications. A modified technique for exploration and retrieval is described.

Results: Nineteen reports were identified and reviewed. Some others could not be translated. In the 32 cases reviewed, there were no gender differences and the third and fourth decades of life were the most common time for this mishap to occur. Fragments were displaced into 5 different tissue spaces. The size of the fragments varied, but the whole tooth and fragment were displaced with equal frequency. Different methods of recovery were used.

Conclusion: The accidental displacement of a lower third molar during attempted extraction is a rare but potentially serious complication. Retrieval should be effected as soon as possible. Because of differences in the direction of displacement, the size of fragment, delay in retrieval, and tissue reactions, no one technique is uniformly applicable. The modified method we suggest appears to save time and have few complications.