case_images: PMC10867549_01
case_images: (a) Preoperative orthopantomogram (OPG) showing extracted maxillary third molars (18 and 28) and impacted mandibular third molars (38 and 48); (b) OPG taken after dislodgement of the mini-screw showing extraction socket of tooth 48 and mini-screw displaced into the soft tissues posterior to the ramus of the right mandible
case_images: cureus-0016-00000052343-i01.jpg
case_images: PMC10867549_01_cureus-0016-00000052343-i01.jpg
case_images: FIG1
case_images: A 30-year-old female patient, with no reported medical illnesses or allergic conditions, was referred to the oral and maxillofacial surgery clinic for extraction of the right mandibular third molar (tooth #48) and subsequent placement of orthodontic mini-screws (TAD) (Figure 1A). While the chest radiograph was unremarkable (Figure 2), OPG revealed the dislodged mini-screw in the soft tissues posterior to the ramus of the right mandible (Figure 1B).
case_images: Unremarkable chest radiograph
case_images: cureus-0016-00000052343-i02.jpg
case_images: PMC10867549_01_cureus-0016-00000052343-i02.jpg
case_images: FIG2
case_images: While the chest radiograph was unremarkable (Figure 2), OPG revealed the dislodged mini-screw in the soft tissues posterior to the ramus of the right mandible (Figure 1B).
case_images: (a) Axial sections of head and neck computed tomography (CT) showing the mini-screw located within the right lateral pharyngeal space and in close proximity to the major blood vessels of the neck; (b) Sagittal sections of head and neck CT showing the screw in the right lateral pharyngeal space
case_images: cureus-0016-00000052343-i03.jpg
case_images: PMC10867549_01_cureus-0016-00000052343-i03.jpg
case_images: FIG3
case_images: CT scan of the head and neck region for the 3D location of the dislodged mini-screw. CT images showed the foreign body dislodged within the right lateral pharyngeal space and close to major blood vessels of the neck (Figure 3).
case_images: Intraoperative fluoroscopy using the C-Arm radiographic imaging system in multiple planes (from left to right - lateral, oblique and anteroposterior) showing the location of the mini-screw in the right lateral pharyngeal space and with respect to the tip of the hemostat
case_images: cureus-0016-00000052343-i04.jpg
case_images: PMC10867549_01_cureus-0016-00000052343-i04.jpg
case_images: FIG4
case_images: With the dissecting forceps in situ, multiple fluoroscopy images in the lateral, oblique and anteroposterior planes were obtained using a portable C-Arm X-ray machine to locate the position of the screw (Figure 4).
case_images: The mini-screw after surgical retrieval
case_images: cureus-0016-00000052343-i05.jpg
case_images: PMC10867549_01_cureus-0016-00000052343-i05.jpg
case_images: FIG5
case_images: After guidance and confirmation through imaging, the foreign body was retrieved successfully (Figure 5).