Comparison of two surgical techniques for the extraction of mandibular horizontally impacted third molars near the mandibular canal: the displacement reduction method and the away-from-nerve method.

OBJECTIVES

To introduce two surgical techniques for extracting horizontally impacted wisdom teeth near the mandibular nerve canal and to assess their effectiveness.

MATERIALS AND METHODS

This study involved patients requiring extraction of horizontally impacted wisdom teeth near the mandibular canal from January to December 2024. Cases were grouped into three categories: close, compressing, and intruding into the mandibular canal. Depending on the tooth's position relative to the nerve canal, it was classified as lingual, middle, or buccal. Extractions were carried out using either the displacement reduction technique or the away-from-nerve method. Surgical time, postoperative swelling, VAS index, and inferior alveolar nerve injuries were documented.

RESULTS

The displacement reduction technique was selected for 50 cases, and the away-from-nerve method for another 50. Among the teeth that contacted the mandibular nerve canal, 80% chose the away-from-nerve method, and among teeth intruding into the nerve canal, 93.1% opted for the displacement reduction technique. When the canal was lingual to the tooth, 81.5% chose the displacement reduction technique, and when buccal, only 23.7% did so (p < 0.05). The displacement reduction technique resulted in a mean surgical time of 15.38 ± 4.35 min, significantly shorter than the away-from-nerve method (12.10 ± 3.60 min, p < 0.05). Patients underwent the displacement reduction technique had lower VAS scores (p < 0.05) and less swelling (p < 0.05). Among all patients, 3 suffered postoperative nerve injuries.

CONCLUSION

Both techniques are viable for extracting horizontally impacted wisdom teeth near the mandibular canal, with minor postoperative reactions and a low risk of postoperative nerve injury.

CLINICAL RELEVANCE

Both surgical techniques for extracting impacted wisdom teeth near the mandibular canals reduce postoperative complications and the risk of nerve injury.