Extraction of low horizontally and buccally impacted mandibular third molars by three-piece tooth sectioning

The aim of this study was to investigate the clinical effect of the extraction of low horizontally impacted mandibular third molars by three-piece tooth sectioning. Sixty patients with low horizontally and buccally-impacted mandibular third molars on both sides were operated on under local anaesthesia. Three-piece tooth sectioning was used on one side (n=60) and the molars were extracted using a high-frequency electric knife, 45° reversed-angle high-speed turbine, and special long crank drill. Each molar was cut into three pieces, which were removed in the following order: middle, root, and crown. One month later, the molars on the other side of each patient's jaw were removed by conventional extraction (n=60) with the same equipment. The crown was cut and removed first, and then the remaining piece was extracted. The duration of the procedure, and incidence postoperative swelling, pain, and trismus were compared between the two groups. The procedure was shorter with the three-piece method (10.05 (0.51) min) than with the conventional method (20.15 (0.88) min, p<0.01). Postoperative swelling, pain, and trismus were all less severe with the three-piece method than with the conventional method (p<0.01). Three-piece tooth sectioning could be used to remove low horizontally and buccally-impacted mandibular third molars, as it can shorten the duration of the procedure, reduce trauma, and reduce the incidence of postoperative complications.