Incidence and predictive factors for perforation of the maxillary antrum in operations to remove upper wisdom teeth: Prospective multicentre study

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British Journal of Oral and Maxillofacial Surgery
Volume 45, Issue 5, July 2007, Pages 387-391

Incidence and predictive factors for perforation of the maxillary antrum in operations to remove upper wisdom teeth: Prospective multicentre study

Daniel Rothamela, Gerhard Wahl, b, Bernd dÌHoedt, c, Georg-Hubertus Nentwig, d, Frank Schwarz, a and J?rgen Becker, a
a - Department of Oral Surgery, Heinrich Heine University, Westdeutsche Kieferklinik, Moorenstr. 5, 40225 D?sseldorf, Germany
b - Department of Oral Surgery, Rheinische Friedrich-Wilhelms-University, Welschnonnenstr. 17, 53111 Bonn, Germany
c - Department of Oral Surgery, Johannes Gutenberg University, Augustusplatz 2, 55131 Mainz, Germany
d - Department of Oral Surgery and Implantology, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany
Accepted 29 October 2006. Available online 11 December 2006.

Objectives
Ectopic mandibular third molar is a rare condition, and information is limited about its causes and characteristics. This article reports a case of ectopic mandibular third molar and reviews the literature on the clinical signs and symptoms and management of this condition.

Study design
We report a case of an impacted mandibular third molar dislocated high on the right side of the mandibular ramus. Thirteen cases of ectopic mandibular third molars reported in the English-language literature over the past 25 years, identified from Pubmed and Medline databases are also reviewed.

Results
Among the 13 case reports identified, 10 occurred in women. Pain and swelling on the ispilateral side of the mandible or the preauricular region were the most common symptoms. Seven cases involved an ectopic mandibular third molar in the condylar or subcondylar region. Eight of the 11 cases included the description of a radiolucent image around the ectopic molar on the radiograph and described diagnosis of a dentigerous cyst. Seven of the ectopic third molars were extracted through intraoral access, and 3 were extracted through extraoral access.

Conclusions
The etiology of ectopic mandibular third molars has not yet been completely clarified. Annual follow-up visits with panoramic radiographs are required for patients with symptom-free highly aberrant wisdom teeth. Treatment should be carefully planned according to the position of the ectopic tooth and the potential for trauma caused by the surgery.