Computer-aided design/computer-aided manufacturing cutting guides for odontectomy of deeply impacted mandibular third molars

Abstract

AIM: To evaluate a new technique for surgical removal of deeply impacted mandibular third molars (DIMTM), using computer-guided cutting guide to maintain inferior alveolar nerve (IAN) integrity and the covering buccal bone.PATIENTS AND METHODS: Eighteen cases indicated for removal of DIMTM. Cone-beam Computed Tomography (CBCTs) used to determine the tooth’s relation to the IAN. Computer-guided software used for fabrication of surgical cutting guide stent to expose the impacted tooth and repositioning of bone after odontectomy without fixation. Clinical assessment included a neurosensory deficit of IAN, pain using a visual analogue scale (VAS), facial swelling, and maximal mouth opening (MMO). CBCTs were taken immediately and six months postoperatively to evaluate position and healing of bone.RESULTS: None of the patients showed a permanent neurological deficit of IAN while all patients showed normal parameters of pain, facial swelling and MMO. CONCLUSION: this technique has shown the accurate determination of the bony window cuts with subsequent preservation of IAN and external oblique ridge.