Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Apr 18:27:100304.
doi: 10.1016/j.tcr.2020.100304. eCollection 2020 Jun.

Unique tooth dislocation into submental space during a pan facial trauma - Importance of an orthopantomogram

Shahi Jahan Shah  1 , Ibrahim Alshahrani  1 , Ashfaq Yaqoob  1 , Rafi A Togoo  1 , Abdullah A Alnazeh  1 , Muhammad Ishfaq Khan  1
Affiliations
Case Reports

Unique tooth dislocation into submental space during a pan facial trauma - Importance of an orthopantomogram

Shahi Jahan Shah et al. Trauma Case Rep. .

Erratum in

Abstract

Background: There are certain reported cases of unusual displacements of teeth involved in a maxillofacial trauma to the maxillary sinus, nasal cavity, gastrointestinal tract or the airway, if worst. All these usually lead to complication the worst being death. So enquiring about them is a very essential part of surveying a maxillofacial trauma patient involving dentition.

Case: This patient was referred to our department for a dental consultation for his ill-defined firm, mildly tender, non-suppurative, submental swelling unresponsive to medication. He had undergone a polytrauma involving his face two months back. An orthopantomogram was ordered which showed a lower central incisor from the fracture site had slipped through the fracture gap into the submental space possibly missed by the CT scan. There was also a lower border splaying at the fracture site. A layer-wise dissection was done extra-orally to retrieve the tooth.

Conclusion: This case envisages the importance of an OPG as an adjuvant to the basic radiographic study, in the emergency room, for a patient with oral and maxillofacial trauma. It also establishes the importance of a meticulous secondary survey, including counting the number of teeth and establishing a correct occlusion to avoid a complication and re-operation. Besides, a medical negligence lawsuit can also arise as some teeth may slip to lungs even.

Keywords: Maxillofacial trauma; Orthopantomogram; Secondary survey; Tooth displacement.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Figures

Fig. 1
Fig. 1
Syringe containing exudate after aspiration of the swelling.
Fig. 2
Fig. 2
OPG showing the displaced tooth lying at base of parasymphysis fracture (blue arrow). Fracture gap at parasymphysis base (black arrow). It also shows miniplates used in ORIF of the Pan-facial fractures. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)
Fig. 3
Fig. 3
The displaced tooth along with the fibrous capsule removed.
Fig. 4
Fig. 4
Skin closure after layerwise suturing.
See this image and copyright information in PMC

References

    1. Michael J., Donald M.B., Swinburn Elizabeth. Tooth in the perioral tissues: a complication of craniofacial trauma. Am. J. Emerg. Med. January 2005;23(1):87–88. - PubMed
    1. Wang H., Yang C.Y., Li Z. Traumatic displacement of teeth into maxillary sinus and the retrieval assisted by computer-assisted navigation: a case report. Medicine (Baltimore) December 2018;97(51) - PMC - PubMed
    1. Chrcanovic B., Bueno S., Silveira D., Luis N., Custódio A. Traumatic displacement of maxillary permanent incisor into the nasal cavity. Oral Maxillofac. Surg. September 2010;14(3):175–182. - PubMed
    1. Henderson C.T., Engel J., Schlesinger P. Foreign body ingestion: review and suggested guidelines for management. Endoscopy. March 1987;19(2):68–71. - PubMed
    1. Cubukcu C.E., Aydin U., Ozbek S. Delayed removal of a primary incisor embedded in the upper lip after dental trauma: a case report about the importance of soft tissue examination. Dent. Traumatol. 2011;27(4):314–317. - PubMed

Publication types

LinkOut - more resources