Virtual Surgical Planning-Assisted Mandibular Sagittal Split Osteotomy for Complex Third Molar Extraction

This case report presents a rare use of mandibular sagittal split osteotomy (MSSO) for the extraction of an impacted third molar, aided by virtual surgical planning. A 32-year-old male presented for third molar removal, but clinical examination revealed the right third molar was not visible intraorally, and access was limited due to restricted mouth opening and tongue mobility. Cone-beam computed tomography confirmed a horizontally impacted right mandibular third molar. Due to the tooth's position and proximity to the inferior alveolar nerve, MSSO was selected. Virtual surgical planning and a 3D-printed surgical guide were used to plan and execute the procedure. The molar was successfully extracted while preserving the nerve, and the osteotomy was stabilized with a 2.0 4-hole miniplate. The patient experienced no postoperative complications or occlusal changes. This case supports MSSO, combined with virtual planning, as a safe and effective option for extracting impacted teeth in complex anatomic locations.