SİGMOİD ÇENTİKTEKİ MANDİBULAR ÜÇÜNCÜ MOLARLAR: NADİR BİR OLGU SUNUMU VE KLİNİK YÖNETİMİ

Year 2025, Volume: 8 Issue: 1, 63 - 68, 04.03.2025

Javanshir Asadov , Tuğba Kuşlu , Begüm Genç , Sırmahan Çakarer , Cemil İşler

https://doi.org/10.26650/JARHS2025-1582778

Abstract

Ektopik mandibular üçüncü molar dişler (EMTM’ler), özellikle sigmoid çentik gibi olağan konumundan oldukça uzakta nadiren görülmektedir. EMTM etiyolojisinde gelişimsel anomaliler, patolojik oluşumlar, travma ve iatrojenik faktörler rol oynamaktadır. EMTM’ler genellikle asemptomatiktir ve rutin radyografik incelemeler sırasında tespit edilirler. EMTM’ler sıklıkla kist ve apse gibi patolojilerle ilişkili olarak yaşamın dördüncü dekadından sonra daha sıklıkla kadınları etkilemektedir. Bu olgu sunumu, sigmoid çentikte yerleşen bir EMTM ile ilişkili dentigeröz kist nedeniyle şişlik, ağız açıklığında kısıtlılık ve enfeksiyon şikayetleriyle başvuran 49 yaşında bir erkek hastayı rapor etmektedir. Klinik ve radyolojik muayene sonucunda EMTM’nin ve kistin lokalizasyonu ve etkilediği anatomik yapılar belirlenmiştir. Cerrahi yaklaşıma karar verilirken, üç boyutlu(3B) görüntüleme sonucunda elde edilen veriler göz önünde bulundurularak cerrahiden kaynaklanabilecek riskler en aza indirilmeye çalışılmıştır. İntraoral cerrahi yaklaşımla kist enükleasyonu ve gömülü diş çekimi ardından semptomlarda gerileme ve ağız açıklığında artış görülmüştür. Yapılan literatür taraması sonucunda EMTM’lerin etkin klinik yönetimi için doğru teşhis ve vakaya özgü cerrahi yaklaşımların önemi vurgulanmaktadır.

Keywords

Ektopik üçüncü molar, sigmoid çentik, dentigeröz kist

MANDIBULAR THIRD MOLARS IN THE SIGMOID NOTCH: A RARE STUDY AND CLINICAL MANAGEMENT

Abstract

Ectopic mandibular third molars (EMTMs) are uncommon, especially in atypical locations like the sigmoid notch. Their aetiology includes developmental anomalies, pathological conditions,trauma, and iatrogenic factors. EMTMs are uncommon and frequently asymptomatic, typically identified during routine radiographic examinations. Often associated with pathologies such as cysts and inflammation, EMTMs predominantly affect females after the fourth decade of life. This case report presents a 49-year-old male patient who presented with symptoms of swelling, limited mouth opening, and infection, attributed to an EMTM in the sigmoid notch associated with a dentigerous cyst. Radiological imaging revealed the precise location and extent of the EMTM and cyst. The choice of surgical approach, based on 3D imaging, should minimise risks and optimise outcomes. Surgical management involved an intraoral approach for extraction of the impacted tooth and enucleation of the cyst, leading to the resolution of symptoms and restoration of normal mouth opening. Literature review emphasises the significance of accurate diagnosis through advanced imaging techniques and tailored surgical strategies for the effective management of EMTMs.

Keywords

Ectopic third molar, sigmoid notch, dentigerous cyst

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