J Korean Assoc Oral Maxillofac Surg.  2011 Apr;37(2):137-141. 10.5125/jkaoms.2011.37.2.137.

Injury of submandibular gland and lingual nerve as complication third molar tooth extraction in mandible : a case report

• Lim JS
• Yoon HJ
• Lee SH

• KMID: 2137004
• DOI: http://doi.org/10.5125/jkaoms.2011.37.2.137

Abstract

The extraction of an impacted third molar tooth is associated with many complications during the procedure and postoperative care. These complications include bleeding, swelling, pain, infection, as well as root fracture, proximal tooth injury, alveolar bone fracture, lingual nerve and inferior alveolar nerve injury etc. With the exception of a fractured root dislocation in the submandibular space, no direct submandibular gland injury related to extraction surgery has been reported until now. A 40 year old man visited the department of oromaxillofacial surgery at Yeouido St. Mary's Hospital for an extraction of the right mandible third molar. A partial third molar impaction was diagnosed by a clinical and radiographic examination. A surgical tooth extraction was practiced including buccal cortical bone osteotomy. During socket curettage, an encapsulated cyst-like lesion and a verified 3x3 cm neoplasm in the apically lingual direction were found during process of dissection. A biopsy confirmed that the neoplasm involved the submandibular gland and nerve trunk. This unusual anatomical organ injury during the surgical tooth extraction procedure is reported as a new complication during impacted third molar extraction.

Keyword

Third molar; Intraoperative Complications; Submandibular gland; Lingual nerve

MeSH Terms

Biopsy
Curettage
Dislocations
Fractures, Bone
Hemorrhage
Intraoperative Complications
Lingual Nerve
Mandible
Mandibular Nerve
Molar, Third
Osteotomy
Postoperative Care
Submandibular Gland
Tooth
Tooth Extraction
Tooth Injuries

Figure

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  Fig. 1. Preoperative panoramaview. We diagnosed partial third molar impaction by radiographic examination.

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  Fig. 2. Histologic finding.(H&E staining, original magnification x100) We confirmed that the neoplasm involved submandibular gland (line arrow) and nerve trunk (dot arrow).

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  Fig. 3. Postoperative dental CT scan coronal view, non enhanced. We verified lingual bone breakage and partial resorption inner cortex of mandible.(CT: computed tomography)

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  Fig. 4. Postoperative salivary gland CT scan coronal view, enhanced. We confirm submandibular gland close to lingual cortex bone and we diagnosed mild swelling and inflammatory change of submandibular gland due to tooth extraction injury.(CT: computed tomography)

Reference

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