Unique Complications after Wisdom Teeth Removal: Case Reports

Complications can occur after having wisdom teeth surgery, see http://www.teethremoval.com/complications.html. Some of these complications are pretty rare and unusual. Recently in Oral Surgery several case reports have been reported describing some rare complications after wisdom teeth surgery.

woman vision double - Unique Complications after Wisdom Teeth Removal: Case Reports
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In the article titled “Spread of infection to skull base via infratemporal fossa after dental extraction related to the use of a high-speed hand piece: a case report” by Moore et al. appearing in Oral Surgery in 2018 (vol. 11, pp. 121-124) discussion is made of a 36 year old woman who had a lower right wisdom tooth removed. The woman developed a deep fascial infection that required formal exploration and drainage. The authors speculate that the woman experienced swelling and infection because of the use of an air driven high-speed hand piece used in the extraction. Forced air from the hand piece lead to development of subcutaneous emphysema which created a path for pathogens. The infection then migrated from the fascial planes into the medial pterygoid, infra-temporal spaces and into the base of skull. The woman required two intensive surgeries and 11 days in the hospital with 9 of those days in intensive care before making a recovery. The authors state

“This case report serves to highlight the rare but possible life threatening consequences of using a high-speed dental hand piece for oral surgical procedures in apparently fit and health[y] individuals.”

In the article titled “Accidental displacement of mandibular third molar root into the sublingual space and delayed removal” by Yamashita et al. appearing in Oral Surgery in 2018 (vol. 11, pp. 153-156) discussion is made of a 42 year old woman who had lower left wisdom tooth removed 5 years earlier. The woman presented with pain and swelling and a panoramic xray was taken where a tooth-like radiopaque lesion in the left mandible was noted which prompted a follow up computed tomography scan. After intraoral examation the lesion was eventually diagnosed as a remnant wisdom tooth root left from the extraction 5 years earlier. The patient was not aware because the dentist had failed to tell her about any accidental displacement of the tooth into the sublingual space. The patient was given general anesthesia and an elevator and forceps was used to remove the wisdom tooth root. The woman made a full recovery. The authors state

“…even experienced surgeons may accidentally displace a tooth or its root on occasion…Some dentists who perform extraction do not inform patients of complications involving tooth displacement at the time of surgery…which results in delayed removal of the displaced tooth.”

In the article titled “Maxillary tuberosity fracture and ophthalmologic complications following removal of maxillary third molar” by Baba et al. appearing in Oral Surgery in 2017 (vol. 10, pp. 43-47) a discussion is made of a 35 year old woman who had an upper left wisdom tooth removed. Following the extraction excessive hemorrhage occurred and maxillary tuberosity fracture was seen which resulted in the woman being taken to a hospital. Before arriving at the hospital, the woman had both the upper wisdom tooth and the fractured tuberosity removed. While at the hospital the woman was given intravenous antibiotics for 4 days and steriods for 2 days while at the hospital of which she stayed for four days. She was examined by an ophthalmologist and found to have slight diplopia which is were one perceives 2 images of a single object. Eleven days after the extraction the woman’s diplipia was gone. A one year follow-up showed the woman had good bone healing in the maxillary tuberosity region. The authors say that the woman’s hemorrhage was believed to occur due to injury to the posterior superior alveolar artery after the tuberosity fracture. The authors state that when discovering a maxillary tuberosity fracture during teeth removal appropriate intervention must be performed to prevent tuberosity bleeding in order to prevent ophthalmologic complications.

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