Forced extrusion for removal of impacted third molars close to the mandibular canal

impacted mandibular third molars can be located in close proximity to the mandibular canal. this creates a risk for the nerve or artery injury. these are contained in the canal. however, the impacted third molar can be moved coronally by orthodontic means, after removal of overlying bone, and safely extracted. the orthodontic intervention slowly moves the tooth apex away from the mandibular canal and reduces the potential for a neural injury. this method may be useful for older patients with root apices that approximate or are actually located in the mandibular canal. this technique needs further study. there is a theoretical potential for neural or arterial injury from physical contact of the tooth apex as it moves by or through the mandibular canal.