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


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.


CONCLUSIONS
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.
Huang
I-Yueh
IY
School of Dentistry, College of Dental Science, Kaohsiung Medical University, Kaohsiung, Taiwan.
Wu
Chung-Wei
CW
Worthington
Philip
P
D005547:Foreign Bodies / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications; D008334:Mandible; D008964:Molar, Third / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D011862:Radiography, Panoramic; D013524:Surgical Flaps; D007507:Therapeutic Irrigation; D014084:Tooth Avulsion / Q000209:etiology / Q000601:surgery; D014081:Tooth Extraction / Q000009:adverse effects*; D014092:Tooth Root / Q000601:surgery; D020390:Tooth Socket / Q000601:surgery