[Mandibular third molar extractions with proximity to the inferior alveolar nerve canal: what are the alternatives?]

Abstract

Throughout the evolution, modern diet became softer and led to less attrition and less mesial migration of teeth resulting in an increased incidence of teeth impaction. When a mandibular third molar extraction is indicated, damage to the inferior alveolar nerve (IAN) is one of the most important complications. The objective of this review is to provide an overview of the alternative treatment modalities to total removal for a third mandibular molar in cases of proximity to the inferior alveolar nerve. Among the discussed options are: Orthodontic intervention to slowly move the tooth apex away from the mandibular canal and thus reducing the potential for neural injury during extraction; staged approached involving removal of the mesial portion of the crown creating a space for mesial migration of the teeth; and Coronectomy which include removing of the tooth crown while leaving the root undisturbed.