A Novel Orthodontic Extraction Method for Removal of Impacted Mandibular Third Molars in Close Proximity to Inferior Alveolar Nerve

J Oral Maxillofac Surg. 2019 Aug;77(8):1575.e1-1575.e6. doi: 10.1016/j.joms.2019.04.013. Epub 2019 Apr 19.

Abstract

Purpose: The present study has proposed a novel orthodontic extraction method with a removable appliance to avoid inferior alveolar nerve (IAN) injury during impacted mandibular third molar removal.

Patients and methods: In the present study, 16 patients were enrolled and divided into 2 groups per patient choice. In the orthodontic extraction group (n = 8), a removable appliance was first applied to move the root tips away from the IAN, and the tooth was subsequently removed. In the traditional extraction group (n = 8), each patient had the tooth removed immediately by the same surgeon.

Results: All teeth were extracted successfully. All 8 patients in the orthodontic extraction group had had their impacted mandibular third molar removed without IAN injury after surgery. In contrast, 4 patients in the traditional extraction group had experienced transient IAN injury, and the symptoms persisted for 2 to 8 weeks. None of the patients experienced permanent IAN damage.

Conclusions: Orthodontic extraction with a removable appliance to separate the IAN and impacted mandibular third molar could be a good alternative treatment option to avoid IAN injury in high-risk cases.

Publication types

  • Clinical Trial

MeSH terms

  • Humans
  • Mandible
  • Mandibular Nerve
  • Molar, Third*
  • Tooth Extraction* / adverse effects
  • Tooth, Impacted* / surgery
  • Trigeminal Nerve Injuries* / etiology