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Mesiolingual root rotation for horizontal mandibular third molar extraction: position classification and surgical

Zhou-Xi Ye¹, Chi Yang²

¹Shanghai Stomatological Hospital, Fudan University, Shanghai, People's Republic of China.

Scientific Reports

|November 2, 2017

Summary

A new mesiolingual root rotation technique effectively extracts difficult horizontal mandibular third molars. This method, especially for deep impactions, shows promise in reducing nerve injury risks during wisdom tooth removal.

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Area of Science:

Dentistry
Oral Surgery
Surgical Innovation

Background:

Horizontal mandibular third molars present significant extraction challenges due to bone resistance and proximity to adjacent teeth.
Existing extraction methods can be complex and carry risks of complications.

Purpose of the Study:

To evaluate the efficacy of a novel mesiolingual root rotation technique for extracting horizontally impacted mandibular third molars.
To compare the outcomes of this new method with the traditional crown distal rotation technique.

Main Methods:

Retrospective review of 73 horizontal third molar extractions using piezosurgery.
Classification of impaction depth into three positions (I, II, III) based on 3D CBCT scans.
Surgical simulation and application of traditional (crown distal rotation) and novel (mesiolingual root rotation) methods.

Main Results:

The novel mesiolingual root rotation method was predominantly used for deep impactions (Position III, 83.33%).
The traditional crown distal rotation was favored for shallower impactions (Position I, 79.17%; Position II, 57.89%).
Temporary inferior alveolar nerve injury occurred in two cases with the traditional method (Position II) and one case with the novel method (Position III).

Conclusions:

Mesiolingual root rotation is an effective technique for extracting horizontal mandibular third molars.
This novel method is particularly advantageous for deeply impacted wisdom teeth.
The technique may offer a reduced risk profile for nerve injuries compared to traditional approaches.