Incomplete Sagittal Split Osteotomy for the Extraction of a Fully Impacted Lower Third Molar: A Case Report
Ori Blanc*, Andrei Krasovsky*, Dekel Shilo, Tal Capucha, Chaim Ohayon and Adi Rachmiel
October 28, 2023
DOI : 10.56831/PSSRP-02-069
Background: The sagittal split osteotomy method for extraction of the mandibular third molars can be used in cases of deeply seated teeth, positioned in proximity to the mandibular canal, jeopardizing the integrity of the inferior alveolar nerve and the mandible itself. The classic sagittal split osteotomy approach, adopted from orthognathic surgery, may increase the risk of postoperative malocclusion and Temporomandibular joint dysfunction. For this reason, we would like to purpose a modified technique of sagittal split osteotomy that can be used for extractions.
Methods: This study presents a case of using a modified incomplete sagittal split osteotomy approach for the extraction of a deeply impacted right mandibular third molar in a 43-year-old man under general anesthesia.
Results: Only the superior border of the mandibular cortex was separated for approaching the impacted tooth while leaving the inferior cortex intact. After the surgery no inferior alveolar nerve sensory deficit was observed and the incomplete fracture was reduced back to the original anatomical position.
Conclusions: We suggest using the incomplete sagittal split osteotomy technique in deeply impacted third molars which pose a high risk when extracted. It allows for superior healing with perfect alignment of the segments.
Keywords: Sagittal split osteotomy; Third molars; Extraction; Wisdom teeth; Impacted
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