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A Digital Approach to Extracting Horizontally Impacted Mandibular Third Molars: The Cross-Sectioning Method.
Kejiong Wu1, Yuan Xie1, Fangming Dong1
1Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
Summary
The novel Cross-sectioning method for impacted third molar extraction significantly reduces operation time, pain, and swelling. This technique offers a structured approach for improved surgical efficiency and resident training.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Education
Background:
- Surgical extraction of horizontally impacted mandibular third molars is complex and technique-sensitive.
- Resident training in this procedure presents significant challenges due to the need for precision and experience.
Purpose of the Study:
- To introduce and evaluate the efficacy of the Cross-sectioning method for impacted third molar extraction.
- To minimize bone removal and improve procedural outcomes compared to traditional techniques.
Main Methods:
- A comparative study involving 400 patients (200 per group) comparing the Cross-sectioning method with the Traditional method.
- Utilized Cone Beam Computed Tomography (CBCT) for digital measurements to define an optimal odontosection depth (9 mm at 75°).
- The Cross-sectioning protocol involved dividing the tooth into four segments for sequential removal.
Main Results:
- The Cross-sectioning group exhibited significantly shorter operation times (p < 0.01) and reduced postoperative pain and swelling compared to the Traditional group.
- Subgroup analysis (Pell and Gregory classification) showed superior outcomes for Cross-sectioning in Horizontal-IIA, IIB, and IIC cases regarding operation time, swelling, and complications.
- Statistically significant improvements were noted across various classifications (p < 0.05 and p < 0.01).
Conclusions:
- The Cross-sectioning method effectively reduces bone removal and adjacent tooth resistance during impacted third molar extraction.
- This technique provides a structured, precise, and clinically advantageous approach for both experienced surgeons and residents.
- The method enhances procedural efficiency and minimizes complications, leading to improved postoperative outcomes.
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