Extraoral surgical management of a third molar displaced to the mandibular inferior border: Case report

Abstract

Introduction: Surgical extraction of third molars is a common procedure, although not without risks. A rare but significant complication is the displacement of teeth or root fragments into deep anatomical planes, such as the mandibular border, posing both diagnostic and surgical challenges—particularly when undetected for years. Case presentation: We report the incidental finding of an inverted and displaced lower right third molar at the mandibular inferior border in a 35-year-old female patient undergoing evaluation for orthofacial surgery. The patient was asymptomatic and reported a previous extraction of the same tooth 18 years earlier. The molar was identified using cone-beam computed tomography (CBCT) and successfully removed via a submandibular extraoral approach under general anesthesia. Conclusion: This case highlights the importance of thorough imaging evaluation in patients with prior surgical history and the need for individualized surgical planning. A submandibular approach provides a safe and effective option for accessing deeply positioned third molars, reducing infection risk and preserving adjacent anatomical structures.