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

OBJECTIVE: This study aimed to investigate the application of the palatal approach for surgical removal of IMTM, and to evaluate its success rate, surgical duration, postoperative outcomes, and incidence of complications. METHOD: Patients with mesioangularly IMTM (Archer Classification Class B) in the none-buccal position to the adjacent second molar, which were indicated for surgical removal, were enrolled in this study. The patients were assigned into two groups according to the surgical approach: the buccal or palatal approach. The impacted tooth positions, diagnosis, past dental and medical history, and radiographic examination were recorded pre-operatively. The duration, surgery details, and surgical complications were documented during the surgery. RESULT: 40 teeth were enrolled in our study. All teeth were removed completely. 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 incidence 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.