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Randomized Controlled Trial
. 2025 Jul 2;25(1):1036.
doi: 10.1186/s12903-025-06402-7.

Traditional vs. orthodontic extraction of impacted teeth related to the inferior alveolar nerve: a randomized control trial

Senem Askin Ekinci  1 , Zeynep Beyza Kiristioglu  2 , Ozan Ates  2 , Gokhan Gocmen  2
Affiliations
Randomized Controlled Trial

Traditional vs. orthodontic extraction of impacted teeth related to the inferior alveolar nerve: a randomized control trial

Senem Askin Ekinci et al. BMC Oral Health. .

Abstract

Background: The aim of this prospective randomized controlled trial was to compare the effects of orthodontic and traditional extraction methods on nerve injury following the extraction of impacted third molars close to the inferior alveolar nerve and to demonstrate the impact of factors such as gender, age, systemic diseases, the side of the third molar, its position, and classification on nerve recovery.

Methods: Patients with impacted third molars close to the inferior alveolar nerve and an indication for impacted third molar extraction were included in the study. The patients were divided into two groups according to the surgical approach to be applied.

Results: Preoperative 2-point discrimination (2PD) test values, as well as postoperative 2PD test and visual analog scales (VAS) values on the 7th day, 14th day, and 1st, 3rd, and 6th months, were compared. In the traditional extraction group, the results of the 2PD test were statistically significantly higher on the 7th day, 14th day, 1 month, and 3 months compared to the orthodontic extraction group (P < 0.05). Sex, age, systemic disease, M3 side, position, and classification had no statistically significant effect on nerve recovery (P > 0.05).

Conclusions: The orthodontic extraction was found to be safer than traditional extraction in terms of nerve injury for high-risk M3s.

Clinical trial registration: This study was registered on www.

Clinicaltrials: govin13/02/2024 .

Clinical trial number: NCT06270784.

Keywords: Impacted tooth; Inferior alveolar nerve; Mandibular nerve injuries; Orthodontic extrusion; Third molar; Tooth extraction.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The present study was performed according to the guidelines of the Helsinki Declaration and complied with the CONSORT guidelines. Ethical approval was obtained from Marmara University Faculty of Medicine Clinical Research Ethical Commitee (IRB Approval No. 09.2024.122). Every patient signed a written informed consent form. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Selecting the anchorage site according to the position of the mandibular third molar for orthodontic extrusion. The red arrows indicate the force vectors. (A-C) The mandibular ramus area was used in the mesioangular, horizontal, and vertical positions. (D) The zygomaticomaxillary buttress area was used in the distoangular position
Fig. 2
Fig. 2
The stages of the first operation of the orthodontic extraction group. (A) Preoperative orthopantomography image. (B) Incisional biopsy and osteotomy procedure following elevation of the mucoperiosteal flap. (C) Placement of an orthodontic button and mini-screw. Attachment of the elastic and ligature wire fixed to the button to the mini-screw. (D) Closure of the flap
Fig. 3
Fig. 3
Observation of orthodontic movement of the mandibular third molar on orthopantomography images. (A) Postoperative 7th day follow-up. (B) Postoperative third week follow-up. (C) Postoperative fifth week follow-up. (D) Postoperative seventh week follow-up
Fig. 4
Fig. 4
Comparison of the position of the mandibular third molar in preoperative and postoperative cone beam computed tomography images. (A) Preoperative cone beam computed tomography image. (B) Postoperative cone beam computed tomography image
Fig. 5
Fig. 5
The stages of the second operation of the orthodontic extraction group. (A) Preoperative intraoral view. (B) Elevation of the mucoperiosteal flap and the new position of the extruded mandibular third molar. (C-E) Extraction of the mandibular third molar. (F) Closure of the flap
Fig. 6
Fig. 6
CONSORT flow-diagram of patient selection and allocation
Fig. 7
Fig. 7
The distribution of patients present and not present inferior alveolar nerve injury in groups
See this image and copyright information in PMC

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