Surgical Removal of Impacted Lower Second Molar in Transverse Position: A Case Report

Introduction: An impacted tooth is one that has not reached the occlusal plane due to a mechanical obstruction, which may include an adjacent tooth, a supernumerary tooth, or an odontoma. Lower third molars are the most frequently impacted teeth, whereas second molars are impacted less often. Currently, diagnostic imaging, such as tomography, is crucial for determining the treatment plan. For the extraction of impacted teeth, a vestibular approach is generally recommended, and for molars, odontectomy prior to tooth luxation and avulsion is advised. Objective: This study was aimed at describing the surgical technique for the flap extraction of an impacted lower second molar in a transverse position with the crown oriented towards the lingual side. Case Presentation: A 17-year-old male patient presented with pain in the lower left molar region. Clinical examination revealed the absence of Teeth 37 and 38. Tomographic imaging showed Tooth 37 in a transverse position with the crown oriented lingually and Tooth 38 in a vertical position. Extraction of Tooth 37 was performed using a vestibular approach and odontectomy due to space constraints. Conclusions: Retention of permanent second molars is rarely reported in the literature. It is advisable to apply all possible methods to position these teeth in the occlusal plane to ensure proper masticatory function. However, there are cases where extraction is necessary due to space limitations, and alternative solutions for replacing the lost tooth should be explored.