Orthodontic extraction of mandibular third molar to avoid nerve injury and promote periodontal healing.
OBJECTIVE
Impacted mandibular third molar extraction is a common procedure in oral surgery, not without risk of nerve injury and periodontal defects on the distal aspect of the adjacent second molar. The "orthodontic extraction" is proposed as a method to avoid mandibular nerve injury during the extraction of a deeply embedded third molar and to prevent or limit such periodontal problems.


METHODS
A 28-year-old man presented a deeply impacted left mandibular third molar that required extraction. Radiographs revealed a very slight quantity of bone at the distal surface of the adjacent second molar. The third molar was extruded according to the "orthodontic extraction" technique. A 3-month retention phase elapsed to ensure adequate bone maturation and the tooth was finally extracted.


RESULTS
No neurological complications occurred. A minimal residual bone defect at the distal surface of the adjacent second molar was detected radiographically both post-operatively and at the 3-year follow-up.


CONCLUSIONS
Orthodontic extraction makes third molar removal easier and has no neurological risk. This procedure, followed by a 3-month retention phase, appears to be effective in preventing or limiting the development of periodontal problems on the distal aspect of the adjacent second molar.
Bonetti
Giulio Alessandri
GA
Department of Orthodontics, University of Bologna, Bologna, Italy. alessandribonetti@libero.it
Parenti
Serena Incerti
SI
Checchi
Luigi
L
D000328:Adult; D001641:Bicuspid / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008340:Mandibular Nerve / Q000473:pathology*; D008964:Molar, Third / Q000473:pathology* / Q000601:surgery; D050793:Orthodontic Extrusion / Q000379:methods*; D010519:Periodontium / Q000293:injuries / Q000473:pathology*; D014081:Tooth Extraction; D014095:Tooth, Impacted / Q000601:surgery / Q000628:therapy*; D061221:Trigeminal Nerve Injuries; D014945:Wound Healing / Q000502:physiology