Imaging Sci Dent.  2014 Jun;44(2):171-175. 10.5624/isd.2014.44.2.171.

An alternative approach to extruding a vertically impacted lower third molar using an orthodontic miniscrew: A case report with cone-beam CT follow-up

• Cortes AR
• No-Cortes
• Cavalcanti MGP
• Arita ES

• KMID: 1799601
• DOI: http://doi.org/10.5624/isd.2014.44.2.171

Abstract

One of the most common oral surgical procedures is the extraction of the lower third molar (LTM). Postoperative complications such as paresthesia due to inferior alveolar nerve (IAN) injury are commonly observed in cases of horizontal and vertical impaction. The present report discusses a case of a vertically impacted LTM associated with a dentigerous cyst. An intimate contact between the LTM roots and the mandibular canal was observed on a panoramic radiograph and confirmed with cone-beam computed tomographic (CBCT) cross-sectional cuts. An orthodontic miniscrew was then used to extrude the LTM prior to its surgical removal in order to avoid the risk of inferior alveolar nerve injury. CBCT imaging follow-up confirmed the success of the LTM orthodontic extrusion.

Keyword

Molar, Third; Orthodontic Extrusion; Cone-Beam Computed Tomography

MeSH Terms

Cone-Beam Computed Tomography*
Dentigerous Cyst
Follow-Up Studies*
Mandibular Nerve
Molar, Third*
Oral Surgical Procedures
Orthodontic Extrusion
Paresthesia
Postoperative Complications

Figure

• 

  Fig. 1 Initial cross-sectional cone-beam computed tomographic (CBCT) images of the site show the contact between the mandibular canal and the curvatures of the mesial (A) and distal (B) roots, depicted in different CBCT cuts.

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  Fig. 2 A clinical photograph shows the lower third molar before (A) and after (B) orthodontic extrusion.

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  Fig. 3 Initial (A) and final (B) coronal panoramic CBCT reconstruction images of the site show the relationship between the lower third molar roots and the mandibular inferior alveolar canal.

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  Fig. 4 Initial (A) and final (B) cross-sectional CBCT images of the site show the relationship between the lower third molar roots and the mandibular inferior alveolar canal.

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  Fig. 5 Mesial (A) and lingual (B) views of the extracted lower third molar show the root curvature (arrow), which comes into contact with the mandibular canal before orthodontic extrusion with the miniscrew.

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