Inward fragmentation and socket preservation in complex mandibular third molar surgery - a case report.

Open extraction sockets following inward fragmentation of partially erupted mandibular third molars may compromise the hard tissue regeneration and lead to postoperative complications. In the case report, we present socket preservation to seal the open alveolous without flap displacement.  A female patient  aged 22,  presented for removal of a partially erupted M3M was operated on via occlusal inward fragmentation under magnifying endoscopic vision. Critical nerve structures were identified and protected before socket preservation with resorbable in situ hardening TCP particles was performed. The  alveolar bone site  healed uneventful, panoramic and cross-sectional  conebeam reformats confirmed an complete hard tissue maintanence. Endoscopically assisted inward fragmentation combined with  socket preservation leads to the maintenance of adjacent hard tissues without need for flap transposition in complex anatomical sites.