title: Orthodontic extraction of mandibular third molar to avoid nerve injury and promote periodontal healing.
abstract: 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.
authors.affiliation: Department of Orthodontics, University of Bologna, Bologna, Italy. alessandribonetti@libero.it
authors.forename: Giulio Alessandri
authors.initials: GA
authors.lastname: Bonetti
authors.forename: Serena Incerti
authors.initials: SI
authors.lastname: Parenti
authors.forename: Luigi
authors.initials: L
authors.lastname: Checchi
mesh_terms: 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