Objectives:A case of a rare complication of erupted lower third molar extraction has been reported. Methods: A 31-year-old-man had a progressive swelling of the right neck region, severe headache and local pain at the region of lower right third molar for 2 months. A panoramic radiograph revealed presence of a crown of third molar and probably a small bony fragment at the level of the inferior border of the mandible and the retained roots of the tooth was in its socket. The CT scans of the patient demonstrated the lingual perforation of the right mandible. During extraction of the lower right third molar, the tooth and a small amount of lingual cortex have been displaced into the submandibular space. This caused a severe inflammatory reaction. Two months later, the erupted tooth and the bone fragment were removed via extra-oral submandibular approach. Results: The postoperative course of the patient was uneventful. Conclusion: The pathogenesis of this rare complication is discussed.

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