Palatal approach for surgical removal of mesioangularly impacted maxillary third molar - a cohort study

Objective: This study aimed to investigate the application of palatal approach to perform IMTM extraction, and evaluate its operation successful rate, surgical time, postoperative outcomes, and complications incidence. Method Patients, with Class B mesioangularly IMTM in the none-buccal position of the adjacent second molar, were enrolled in this study if the teeth were indicated for extraction. The patients were randomly assigned into two groups according to the surgical approach: buccal approach or palatal approach. The impacted tooth positions, diagnosis, past dental and medical history, and radiographic examination were recorded pre-operatively. During the surgery, the duration time, the surgery detail, and surgical complications were documented. Result 40 teeth were enrolled in our study. All teeth were extracted. The operation time was significantly shorter in the palatal approach group compared to the buccal approach group (13.3 ± 2.8 min vs. 22.3 ± 5.5 min, P༜0.001). The rate of traumatic ulcers of the lips was significantly higher in the buccal approach group than in the palatal approach group (7/20 vs. 0/20, P = 0.008). Conclusion It is more efficient to perform surgery with a palatal approach if a Class B mesioangularly IMTM is located in the non-buccal aspect of the adjacent second molar. Clinical trial registration number: ChiCTR2000040063