Surgical Management of a Mandibular Right Third Molar with Transverse Impaction: A Case Report
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Abstract
This case report aims to describe the clinical findings, radiographic features, diagnosis, treatment planning, surgical procedure, and postoperative follow-up of a patient with
a transversely impacted mandibular right third molar. A 16 years old Thai female patient presented to the dental clinic at Kham Khuean Kaeo Hospital, Yasothon Province, with pain in the right mandibular region, accompanied by a subjective limitation in mouth opening and difficulty eating for approximately one week. The patient reported no underlying systemic disease and no history of drug allergy. Extraoral examination revealed no facial swelling, tenderness, or palpable abnormality, and mouth opening was within normal limits at the time of examination. Intraoral examination showed that the mandibular right third molar was not visible in the oral cavity. The surrounding gingiva and oral mucosa appeared normal, with no clinical signs of inflammation or dental caries.
Periapical radiographic examination revealed that the mandibular right third molar, tooth 48, was impacted in a transverse or buccolingual angulation and was classified as Pell and Gregory Class II, Position C. The tooth was located away from the inferior alveolar canal, and no root resorption of the adjacent mandibular right second molar was observed. Surgical removal of the impacted tooth was performed under local anesthesia. The procedure included an envelope flap design, buccal bone removal, tooth delivery, socket irrigation, and wound closure. Postoperative instructions were provided, and follow-up appointments were scheduled at one week and three months. Healing was uneventful, with no postoperative pain, swelling, infection, dry socket, or neurosensory disturbance of the lower lip and chin.
This case demonstrates that careful clinical examination and appropriate surgical planning can contribute to a safe and successful outcome in the management of transverse mandibular third molar impaction while minimizing the risk of postoperative complications.
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This article is published under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0), which allows others to share the article with proper attribution to the authors and prohibits commercial use or modification. For any other reuse or republication, permission from the journal and the authors is required.References
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