Orthodontic extraction of mandibular third molar to avoid nerve injury and promote periodontal healing.

Aim: Impacted mandibular third molar extraction is a common procedure in oral surgery, not without risk of nerve injury and periodontal defects on the distal aspect of the adjacent second molar. The "orthodontic extraction" is proposed as a method to avoid mandibular nerve injury during the extraction of a deeply embedded third molar and to prevent or limit such periodontal problems. Material and Methods: A 28-year-old man presented a deeply impacted left mandibular third molar that required extraction. Radiographs revealed a very slight quantity of bone at the distal surface of the adjacent second molar. The third molar was extruded according to the "orthodontic extraction" technique. A 3-month retention phase elapsed to ensure adequate bone maturation and the tooth was finally extracted. Results: No neurological complications occurred. A minimal residual bone defect at the distal surface of the adjacent second molar was detected radiographically both post-operatively and at the 3-year follow-up. Conclusions: Orthodontic extraction makes third molar removal easier and has no neurological risk. This procedure, followed by a 3-month retention phase, appears to be effective in preventing or limiting the development of periodontal problems on the distal aspect of the adjacent second molar.