Dental implant causing lateral rectus muscle traumatic laceration

Dental implants are often used in maxillofacial surgery. Extraocular muscle (EOM) laceration is a rare complication of the mandibular-zygomatic drilling accidentally penetrating the orbital space. In a single previous report of a lost lacerated lateral rectus muscle post-dental implantation, the muscle was not found, and transposition of the vertical muscles was performed to restore ocular motility partially. Here we present a case of traumatic laceration of the lateral rectus muscle and a successful reconstruction six weeks after injury. Our case demonstrates the EOM laceration was missed on initial radiological assessment, which led to a delayed surgical exploration. Fortunately, the lacerated muscle was re-attached. Botulinum toxin was injected to the antagonist medial rectus muscle in order to improve surgical outcome. Radiological assessment may not be sufficiently sensitive to detect EOM cut. Therefore, surgical exploration should be performed according to clinical suspicion. Even if the surgical procedure is delayed due to hematoma or edema, there is a potential for complete functional recovery.