Two-stage extraction by partial grinding of impacted mandibular third molar in close proximity to the inferior alveolar nerve

Background: Extraction of impacted third molars often leads to severe complications caused by damage to the inferior alveolar nerve (IAN).

Aim: To proposes a method for the partial grinding of an impacted mandibular third molar (IMM3) near the IAN to prevent IAN injury during IMM3 extraction.

Methods: Between January 1996 and March 2022, 25 patients with IMM3 roots near the IAN were enrolled. The first stage of the operation consisted of grinding a major part of the IMM3 crown with a high-speed turbine dental drill to achieve sufficient space between the mandibular second molar and IMM3. After 6 months, when the root tips were observed to be away from the IAN on X-ray examination, the remaining part of the IMM3 was completely removed.

Results: All IMM3s were extracted easily without symptoms of IAN injury after extraction.

Conclusion: Partial IMM3 grinding may be a good alternative treatment option to avoid IAN injury in high-risk cases.