Abstract: The maxillary third molar is classified as position D when the lowest point of it is located at or above apical third of the root of second molar and near the maxillary sinus. This tooth extraction is difficult and risky. In this case, the "root removal first" strategy was applied to remove the impacted #28 in position D, which was less traumatic and reduced the complications of the adjacent teeth and maxillary sinus injury.

Key words: impaction, maxillary third molars, position D, minimally invasive, complication