Removal of Horizontally Impacted Mandibular Third Molar through Buccal Plate Extirpation and Replacement - An Evaluative Study.

Abstract

Background: An impacted lower wisdom tooth is a common condition encountered in oral surgery. A horizontally impacted lower third molar is associated with more bone removal compared to mesioangular and distoangular impactions.

Objective: The goal was to minimize overall bone removal without compromising the function of the inferior alveolar nerve.

Materials and methods: Twenty-five patients, between 18 and 46 years old, participated in the study-20 females and five males. All patients attended a private clinic with the intention of having their impacted teeth removed. A portion of the buccal cortex, with specific dimensions, was removed from a position lateral to the horizontally impacted wisdom tooth. This was preserved in a sterile wet pack and refixed after tooth removal to minimize bone loss.

Results: A majority of cases involved females (80%) and males (20%). The primary assessment criterion was the viability of the buccal cortex and the presence of any associated complications. One male patient was found to have lost the buccal cortex (accounting for 4% of cases). Two patients complained of temporary paraesthesia, which resolved within 4 months.

Statistical analysis: The data were collected and compiled in Microsoft Excel. The Mann-Whitney U test for nonparametric data was used to analyse descriptive data. The level of statistical significance was set at P < 0.05.

Conclusion: The removal of a small part of the buccal cortex lateral to a horizontally impacted lower third molar is highly predictable when conducted with precision. This is particularly true when the tissue is secured properly, which can subsequently reduce the amount of bone removed.