Modified lingual split technique for extraction of impacted mandibular third molars.

Critical evaluation of existing chisel and bur techniques for removal of impacted mandibular third molars reveals a high incidence of complications. Both approaches require creation of a buccal defect immediately distal to the second molar for the insertion of an elevator, which may cause pocketing to occur postoperatively. The method described here minimizes periosteal reflection, almost completely avoids loss of bone, and effectively reduces the use of rotary instrumentation. The planning of the soft tissue flaps and bony cuts assists in primary wound closure, obliteration of dead space, and reduction of postoperative morbidity.