Orthodontic Extraction of Impacted Mandibular Third Molar Teeth Using the Minimally Invasive Bracket (MIB) System

Aims: To introduce an innovative device named "minimally invasive brace" (MIB) that can efficiently upright mesially impacted mandibular third molars for facilitating extraction. Materials And Methods: Twenty-four partially erupted mandibular third molars with mesioangular impaction and requiring removal were included in this prospective clinical study. The patients were randomly divided into two groups: MIB (n= 16) and control groups (n= 8). In the MIB group, an MIB and MIB smart spring were applied to upright the third molars to allow simple extraction. In the control group, no treatment was provided before the third molar removal. The rate and amount of tooth movement were assessed by pre- and post-operative panoramic radiographs. Duration of the tooth removal and patient comfort using visual analog scale (VAS) scores were compared. The stability of the anchorage provided by the MIB was determined by superimposition of pre- and post-operative intraoral scanner images. The facial swelling was evaluated by superimposition of pre- and post-operative 3-D facial scanner images. Statistical differences between two groups was evaluated using Independent T-test. Results: The MIB system can upright mesially impacted mandibular third molars before extraction with minimal changes to the dental anchorage provided by the MIB. Duration of the tooth removal, patient discomfort, and facial swelling in the MIB group were significantly less than in the control group. Conclusion: The MIB system, using posterior teeth as the anchorage unit and an MIB smart spring, offers a minimally invasive option for uprighting mandibular third molars before extraction and can reduce patient discomfort and facial swelling. Keywords: orthodontic extraction, third molar, uprighting, anchorage, bracket