Features of extracting the third mandibular molars at risk of developing mandibular nerve neuropathy (literature review)

Extraction of the third mandibular molars located in close proximity to the mandibular nerve, is one of the most difficult and frequently performed procedures in surgical dentistry. Current surgical methods of extracting such teeth are either not safe enough or require a lot of time. The purpose of the review is to systematize, evaluate and compare new approaches and methods for extracting the third mandibular molars according to the data of Russian and foreign literature. The analysis of literary sources was carried out in the databases PubMed, eLIBRARY. By the request «extraction of impacted mandibular third molar» 1,937 publications were received and 46 sources were selected. Review and original articles were studied. The information on surgical difficulties and possible complications arising from extracting retained third mandibular molars is presented. New approaches and methods for extracting third mandibular molars in cases of high risk of damage to the mandibular nerve are described and analyzed. It was established that preliminary orthodontic extrusion of the lower third molar reduces the risk of injury to the mandibular nerve and the time of surgical intervention, and this, in turn, reduces the risk of developing general somatic complications.