Ectopic Third Molar in the Mandibular Condyle: An Extraoral Surgical Approach and 10-Year Follow-Up

This report describes the surgical management and long-term follow-up of a dentigerous cyst associated with an ectopic mandibular third molar located in the condylar process. A 55-year-old female presented with pain, limited mouth opening, and a "cyst near the ear." Imaging revealed a radiolucent lesion in the left mandibular ramus associated with an impacted tooth in the condyle. Histopathologic analysis following incisional biopsy confirmed a dentigerous cyst. Given the lesion size and the inaccessible position of the tooth, surgical excision was performed through a preauricular approach under general anesthesia, including removal of the tooth and associated cyst. A 2.0-mm osteosynthesis plate was placed to reduce the risk of iatrogenic fracture. Although rare, ectopic third molars in the condyle are frequently associated with odontogenic lesions. In such cases, an extraoral approach may be required to achieve adequate exposure. A 10-year follow-up demonstrated complete bone healing and no recurrence.