Surgical Removal of Horizontally Impacted Mandibular Third Molar
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Abstract
This case report presents the surgical management of a horizontally impacted mandibular third molar that was completely embedded in bone and located in proximity to the inferior alveolar canal, posing a high risk of inferior alveolar nerve injury.
A 31-year-old Thai male presented with intermittent pain in the right mandibular molar region without identifiable intraoral pathology. Periapical radiographic examination revealed a fully bony impacted right mandibular third molar in a horizontal position, classified as Class II, Position C according to the Pell and Gregory classification. The tooth roots were closely related to the inferior alveolar canal, indicating increased surgical difficulty and an elevated risk of nerve injury. Comprehensive preoperative clinical and radiographic assessments were performed to support treatment planning. Surgical removal was carried out under local anesthesia using techniques aimed at minimizing stress on adjacent anatomical structures, including conservative bone removal and tooth sectioning prior to extraction. The procedure was completed without intraoperative complications. Postoperative healing was uneventful, and no neurosensory disturbances were observed during short-term follow-up or at the one-year review.
This case highlights the importance of thorough preoperative radiographic assessment and appropriate surgical planning in managing horizontally impacted mandibular third molars in proximity to the inferior alveolar canal. Careful case evaluation and the use of suitable surgical techniques can help reduce the risk of nerve injury and achieve safe clinical outcomes, even in high-risk impactions.
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เนื้อหาและข้อมูล (เขียนข้อกำหนด)
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