Clinical evaluation of partial odontectomy for the removal of impacted third molar invading the inferior alveolar nerve canal

doi:10.19438/j.cjoms.2025.04.007

Abstract

Abstract: PURPOSE: To explore the clinical efficacy of performing a second surgical extraction of impacted third molars with roots invading the inferior alveolar nerve canal after partial crown resection. METHODS: A total of 64 cases of mesially or horizontally impacted third molars with roots invading the inferior alveolar nerve canal, which were diagnosed by CBCT and treated in the Department of Oral Surgery at Hefei Stomatological Hospital West Branch from January 2023 to December 2024 were selected. The patients were randomly divided into two groups, with 32 cases in each group. The experimental group underwent partial crown resection first, and then complete tooth extraction was performed 3 or 6 months later. The control group underwent routine one-time tooth extraction. The adverse reactions of the experimental group were observed during the follow-up interval after partial crown resection, and the incidence of lower alveolar nerve injury, infection and dry socket after complete tooth extraction, pain and swelling at 1, 3 and 7 days after surgery were compared between the two groups. RESULTS: After partial crown resection, only 2 patients in the experimental group experienced mild pain, 1 patient had slight swelling, and one impacted tooth developed pericoronitis after eruption. There were no pulp symptoms, and no other abnormalities were observed. After the complete extraction of tooth in both groups, the incidence of inferior alveolar nerve injury in the experimental group was significantly lower than that in the control group(P<0.05), and the degree of postoperative pain and swelling was also significantly milder than that in the control group(P<0.05). CONCLUSIONS: Partial odontectomy can significantly reduce the risk of inferior alveolar nerve injury, minimize surgical trauma, and result in milder postoperative reactions. It is a safer and more effective method for impacted tooth extraction.

Key words: Partial odontectomy, Impacted mandibular third molar, Inferior alveolar nerve canal, Inferior alveolar nerve injury

CLC Number:

R782.1

Yan Weifeng, Chen Zhifang, Lu Luyun. Clinical evaluation of partial odontectomy for the removal of impacted third molar invading the inferior alveolar nerve canal[J]. China Journal of Oral and Maxillofacial Surgery, 2025, 23(4): 355-360.

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