Upper Third Molar Tuberosity Risk — ORE Part 1 MCQ

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ModerateOral SurgeryUpper Third Molar Tuberosity RiskORE Part 1

During surgical removal of a horizontally impacted upper third molar, which structure is most at risk of operative injury?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Maxillary tuberosity

Explanation lettering: C = shown as A · A = shown as B · B = shown as C

A is correct. The maxillary tuberosity is contiguous with the posterior maxillary alveolus and is a recognised structure at risk of fracture during extraction of upper third molars. The key discriminator is that the tooth is upper, not lower. Inferior alveolar nerve injury is a major concern in mandibular third-molar surgery because of the mandibular canal relationship. The lingual nerve is also relevant chiefly to lower third-molar surgery, particularly on the lingual aspect of the mandible. The mental nerve is anteriorly placed near the premolar region and is not at risk in posterior maxillary surgery. The facial nerve is outside the extraction field. Although oroantral communication can also complicate upper third-molar removal, it is not an option; among the listed structures, the maxillary tuberosity is the best answer.

Reference: Gul et al. Risk factors in oroantral communication while extracting the upper third molar: Systematic review. 2018. https://pubmed.ncbi.nlm.nih.gov/35765135/