Skillful management of exodontia complication to prevent dreadful sequelae

Successful surgical treatments depend upon accurate diagnosis, judicious treatment planning, selection and execution of an appropriate surgical technique, and on a well monitored post-operative period. However, despite these precautions, extraction of teeth (particularly third molar) is exposed to the accidents and complications common to all buccomaxillary and facial interventions. A maxillary third molar may be displaced in maxillary sinus, nearby soft tissue, or may migrate in a superioposterior direction towards paraphyrangeal space, or infratemporal fossa. Dislocating the maxillary third molar in infratemporal fossa is one of the worst nightmare as this area has complex anatomy consisting of vital neurovascular tissues and complex fascial spaces. The extent of displacement depends upon anatomical conditions as well as direction and amount of force applied. Complication arises from error in judgment, improper use of instruments, the application of extreme force or failure to obtain full visualization before acting. Various researchers have given their opinion regarding immediate or delayed removal of tooth pushed in infratemporal fossa but almost all agree that each case should be weighed independently for risk and reward before attempting. Here we present a case in which intraoral approach was taken to retrieve the displaced tooth thus preventing potentially dreadful complications.