An unusual case of an inverted and impacted maxillary third molar

Abstract

Inverted and impacted maxillary third molars are an uncommon dental anomaly. The purpose of this case report is to present a rare case of an inverted maxillary third molar whose anatomical position was localised by a panoramic radiograph near the alveolar lobe of the maxillary sinus and the zygomatic process of the maxilla.

Incidental Detection Of A Rare Inverted And Impacted Maxillary Third Molar In A Patient Of Mandibular Unicystic Ameloblastoma

“…However, reviewing English literatures, the frequency of the inverted impacted maxillary third molar has been uncommon. Since the first reported case by Gold and Demby [8], to the best of our knowledge, including the current case, a number of 12 cases of inverted impacted maxillary third molar teeth have been reported [8][9][10][11][12][13][14][15][16]. Importantly, almost all of these cases have been detected using panoramic radiography indicating the importance of this examination tool to detect any potential dental anomalies.…”

“…Moreover, the surgical intervention for inverted molars is more challenging than other types of impactions due to the abnormal position of the crown renders it greatly inaccessible that needs extensive bone removal, excessive bone loss as well as nerve damage is the main drawback in such circumstances. Nevertheless, as aforementioned, due to the possible growth of odontogenic cystic or tumorous lesions in future, the inverted impacted maxillary third molar of the present case was surgically extracted together with the right mandibular lesion, as have also been surgically removed in a number of the previously documented cases [8,9,12,15,16]. We reported, to our knowledge, the first case of the co-existence of inverted third impacted maxillary third molar with a mandibular ameloblastoma during the examination of this mandibular lesion.…”

Bilateral Inverted and Impacted Mandibular Third Molars: A Rare Case Report

“…The NICE guidelines state that only people with pathology, such as unrestorable caries, untreatable pulpal and/or peri-apical pathology, cellulitis, abscess, osteomyelitis, internal or external resorption of the tooth or adjacent teeth, recurrent episodes of pericoronitis, fracture of the tooth, disease of the follicle including cyst/tumor, tooth/teeth impending surgery, or reconstructive dentistry. Third molars that are partially or completely impacted by soft tissue are far more likely to develop plaque buildup and pericoronitis [ 23 ]. Due to the age of the person and deeper positioning of the inverted tooth, its extraction is more complex than the extraction of a normally impacted tooth.…”

“…Several methods, including the use of rotary burs, chisel mallets, Lasers, piezosurgery, etc., may help achieve this goal. While removing maxillary impacted third molars, an oro-antral fistula may form, or a piece of tough tissue may dislodge in the sinus, nose, or infratemporal fossa [ 23 , 24 ]. One of the most important essential stages in removing the inverted tooth is the osteotomy procedure; however, there are a variety of possible approaches, and they may be harmful if employed by an inexperienced practitioner.…”

Inverted and impacted maxillary and mandibular third molar: Unusual case reports with review of the literature

“…Other possible sequelae of their removal include oro-antral fistula formation, displacement of hard tissue fragment into the sinus, nose or the infratemporal fossa. [8] Besides, there is no clear treatment protocol in the literature, so the clinician must weigh the risks and benefits of removing impacted third molars. Risk factors associated with surgical removal should be properly conveyed to the patient, and a written consent obtained from the patient prior to surgery.…”