Extraction of Impacted Mandibular Third Molars Close to Inferior Alveolar Nerve: A Case Report

doi:10.13701/j.cnki.kqyxyj.2025.11.015

Abstract

Abstract: Inferior alveolar nerve injury secondary to extraction of the mandibular third molars (MTM) is a common complication (0.35% to 8.4%) and can cause temporary or permanent nerve damage. Several methods have been proposed to reduce or eliminate this complication, such as orthodontic traction-assisted tooth extraction, crown amputation and root retention, etc. The purpose of these series of cases is to extract mandibular third molars that are in close contact with the inferior alveolar nerve with no or low risk. In this article, we will introduce a case of extraction such molars after removing the eruption of tooth with proximal coronary resistance, and discuss the application value of this method.

Key words: inferior alveolar nerve injury, impacted mandibular third molar, removal of mesial coronary resistance, coronectomy

HOU Yujiao. Extraction of Impacted Mandibular Third Molars Close to Inferior Alveolar Nerve: A Case Report[J]. Journal of Oral Science Research, 2025, 41(11): 1006-1008.

References

[1] Themkumkwun S, Sawatdeenarunat S, Manosuthi P. Surgical removal of third molars in a young adult: review of indications and surgical techniques[J]. J Korean Assoc Oral Maxillofac Surg, 2023, 49(4):184-191.
[2] Salgado-Peralvo ÁO, Kewalramani N, Madruga-González D, et al. Coronectomy of lower third molars in intimate relation to the inferior alveolar nerve: A report of two cases[J]. J Clin Exp Dent, 2024, 16(2):e223-e228.
[3] Wang Y, He D, Yang C, et al. An easy way to apply orthodontic extraction for impacted lower third molar compressing to the inferior alveolar nerve[J]. J Craniomaxillofac Surg, 2012, 40(3): 234-237.
[4] Le LN, Truong KN, Kim VNK, et al. Impacted mandibular third molars close to the inferior alveolar nerve (IAN) coronectomy: A surgical approach with minimal risk of nerve injury[J]. J Maxillofac Oral Surg, 2024, 23(6):1462-1469.
[5] Landi L, Manicone PF, Piccinelli S, et al. A novel surgical approach to impacted mandibular third molars to reduce the risk of paresthesia: A case series[J]. J Oral Maxillofac Surg, 2010, 68(5):969-974.
[6] Patel PS, Shah JS, Dudhia BB, et al.Comparison of panoramic radiograph and cone beam computed tomography findings for impacted mandibular third molar root and inferior alveolar nerve canal relation[J]. Indian J Dent Res, 2020, 31(1):91-102.
[7] Rood JP, Shehab BA. The radiological prediction of inferior alveolar nerve injury during third molar surgery[J]. Br J Oral Maxillofac Surg, 1990, 28(1):20-25.
[8] Ishak MH, Zhun OC, Shaari R, et al. Panoramic radiography in evaluating the relationship of mandibular canal and impacted third molars in comparison with cone-beam computed tomography[J]. Mymensingh Med J, 2014, 23(4):781-786.
[9] Luo Q, Diao W, Luo L, et al. Comparisons of the computed tomographic scan and panoramic radiography before mandibular third molar extraction surgery[J]. Med Sci Monit, 2018, 24:3340-3347.
[10] Renton T, Hankins M, Sproate C, et al. A randomised controlled clinical trial to compare the incidence of injury to the inferior alveolar nerve as a result of coronectomy and removal of mandibular third molars[J]. Br J Oral Maxillofac Surg, 2005, 43(1):7-12.
[11] Cilasun U, Yildirim T, Guzeldemir E, et al. Coronectomy in patients with high risk of inferior alveolar nerve injury diagnosed by computed tomography[J]. J Oral Maxillofac Surg, 2011, 69(6): 1557-1561.
[12] Nemsi H, Tellili N, Bouanene I, et al. Classification of impacted mandibular third molars using cone beam computed tomography based on neurological risks: N.R.C.[J]. Medecine Buccale Chirurgie Buccale, 2017, 23(3) :131-138.
[13] Pogrel MA, Lee JS, Muff DF.Coronectomy: a technique to protect the inferior alveolar nerve[J]. J Oral Maxillofac Surg, 2004, 62(12):1447-1452.
[14] Abu-Mostafa N, AlRejaie LM, Almutairi FA,et al. Evaluation of the outcomes of coronectomy procedure versus surgical extraction of lower third molars which have a high risk for inferior alveolar nerve injury: A systematic review[J]. Int J Dent, 2021, 2021:9161606.
[15] Mann A, Scott JF. Coronectomy of mandibular third molars: a systematic literature review and case studies[J]. Aust Dent J, 2021, 66(2):136-149.
[16] Lee NJ, Jung SY, Park KM, et al. Factors affecting root migration after coronectomy of the mandibular third molar[J]. Medicine (Baltimore), 2021, 100(20):e25974.
[17] Leung YY, Cheung KY. Root migration pattern after third molar coronectomy: a long-term analysis[J]. Int J Oral Maxillofac Surg, 2018, 47(6):802-808.
[18] Sencimen M, Ortakoglu K, Aydin C, et al. Is endodontic treatment necessary during coronectomy procedure?[J]. J Oral Maxillofac Surg, 2010, 68(10):2385-2390.
[19] Pogrel MA. Partial odontectomy[J]. Oral Maxillofac Surg Clin North Am, 2007, 19(1) : 85-91.
[20] Renton T, Hankins M, Sproate C. A randomised controlled clinical trial to compare the incidence of injury to the inferior alveolar nerve as a result of coronectomy and removal of mandibular third molars[J]. Br J Oral Maxillofac Surg, 2005, 43(1): 7-12.
[21] Patel V, Gleeson CF, Kwok J, et al. Coronectomy practice.Paper 2. Complications and long term management[J]. Br J Oral Maxillofac Surg, 2013, 51(4): 347-352.