Extraction of a severely impacted mandibular third molar using a sagittal split osteotomy – a case report


Statement of the problem: Mandibular third molar tooth impaction is a frequently encountered pathological phenomenon in oral and maxillofacial surgery. Deeply impacted mandibular third molars require extensive bone removal to facilitate extraction. Sagittal split osteotomies provide an alternative treatment option, which can preserve bone and reduce the risk of pathological or iatrogenic jaw fracture in high-risk cases.

Purpose of the review: Clinical awareness of alternative extraction techniques is fundamental to the attainment of optimal patient outcomes. This case report provides an overview of the indications, risks, procedure and outcomes of the sagittal split osteotomy as a technique for the removal of a deeply impacted mandibular third molar.

Method: A case report of surgical removal of an impacted third molar and associated dentigerous cyst by sagittal split is presented. Patient consent was obtained prior to surgery. The chart was reviewed, and clinical information gathered and compiled into a case report. A review of the literature was then carried out to compare the technique presented with similar cases.

Conclusion: This case report highlights the value of sagittal split osteotomy for the removal of deeply impacted mandibular third molars. As part of informed consent, clinicians should consider the sagittal split osteotomy as an alternative treatment option for patients with a high risk of mandibular fracture.

Journal of the Irish Dental Association
December 2019/January 2020; 65 (6): 346-351

Dr Sinéad O’Dwyer
BDS(Hons) MFDS Dip Con Sed StR(Oral Surgery)
University College Cork

Dr Mairéad Kelly
Junior House Officer, ublin Dental University Hospital

Mr Dermot Pierse
Consultant Oral and Maxillofacial Surgeon, Dublin Dental University Hospital

Corresponding author: Dr Sinéad O’Dwyer email: sineadmaireadodwyer@gmail.com