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

Abstract

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. 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. 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 8weeks. None of the patients experienced permanent IAN damage. 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.