BIẾN CHỨNG NGHIÊM TRỌNG TỪ RĂNG KHÔN: VIÊM XƯƠNG HÀM – APXE CƠ CẮN DO RĂNG 38 NGẦM LỆCH

Wisdom teeth—often thought to be a normal part of oral anatomy—can actually pose serious risks if they are misaligned, impacted, or not properly monitored and treated in time. The case of a 29-year-old female patient below is a typical example of severe complications caused by a wisdom tooth.

1. Case Overview

The patient was admitted with swelling and pain in the left cheek, inability to open her mouth, and severe swelling in the left cheek area, causing significant pain and affecting eating and daily activities.

Tình trạng sưng to ban đầu của bệnh nhân — Initial swelling condition of the patient

Through examination and diagnosis, the doctor had to perform emergency surgery: removal of inflamed bone, debridement of necrotic bone, excision of necrotic muscle tissue, and extraction of the problematic wisdom tooth. After treatment, the patient’s condition stabilized, but this case serves as a strong warning about the dangers of complications from wisdom teeth.

2. Initial Condition

The 29-year-old female patient was admitted with swelling and pain in the left cheek and restricted mouth opening. According to her history, in March 2025, she experienced similar swelling and pain and was diagnosed with a masseteric abscess, which was treated with antibiotics at a medical facility.

Khối apxe khiến bệnh nhân không há miệng to được — The abscess limited the patient’s ability to open her mouth

About 10 days before hospital admission, the swelling in the left cheek recurred and progressed rapidly: increased swelling and pain, no fever but significantly reduced ability to open the mouth. Recognizing abnormal signs, the patient decided to seek hospital care for specialized treatment.

3. Diagnosis & Treatment Indication

The attending physician conducted a clinical examination combined with necessary tests such as soft tissue ultrasound and facial CT scan. The results showed:

A 5x5 cm swelling mass in the left cheek and jaw angle area, firm and hard on palpation.
Intraoral: limited mouth opening, tooth 38 not visible on the dental arch, no signs of pus.
X-ray and CT imaging: impacted and misaligned tooth 38, extensive lesion spreading to the left masseteric space, with bone loss at the mandibular angle and body.

Tình trạng tiêu xương trên phim CT — Bone loss observed on CT scan

Based on the examination results and imaging, the doctor diagnosed: Left mandibular osteomyelitis – Diffuse abscess in the left buccal – masseter region due to wisdom tooth No. 38.

After the examination, the doctor indicated surgery: removal of inflamed bone, debridement of necrotic bone, removal of necrotic muscle tissue, and extraction of the causative wisdom tooth.

4. Surgical procedure

The patient was indicated for emergency surgery and the following steps were carried out:

Incision and drainage of abscess, cleaning of the lesion
Removal of inflamed bone and periosteum, debridement of necrotic bone
Resection of inflamed masseter muscle
Extraction of teeth No. 28 and 38
Drain placement

5. Outcome

Postoperatively, the patient’s condition was stable and continued to be monitored and treated according to the postoperative protocol.

Kết quả sau phẫu thuật — Postoperative result

WISDOM TEETH – IF NOT DETECTED EARLY, CAN BECOME A ‘TICKING TIME BOMB’ FOR OROFACIAL HEALTH

The above case is a clear warning about the risk of severe complications from misaligned/impacted wisdom teeth if not properly monitored and managed. Wisdom teeth can be the cause of pericoronitis, leading to masseteric abscess – a serious complication that may spread, affecting jaw function, causing bone loss, or even threatening life if the infection extends to the neck or mediastinum.

The above patient case clearly shows that wisdom teeth – if not properly monitored and treated – can lead to serious consequences, directly affecting health and quality of life. Proactive examination, early diagnosis, and appropriate specialist treatment are key factors in preventing dangerous complications from impacted or misaligned wisdom teeth.

If you are experiencing pain, swelling in the jaw angle area, or suspect an abnormal wisdom tooth eruption, please contact Herident Dental Clinic via hotline 1900 5089 for timely consultation and management. Oral health cannot wait!