Access to the mandibular angle for removal of pathology poses a unique challenge to surgeons. Intraoral approaches result in considerable bone removal and potential damage to the inferior alveolar nerve (IAN). Extraoral approaches are associated with a cutaneous scar and the potential for facial nerve damage. This report describes the case of a 53-year-old man with a deeply impacted third molar associated with a cystic lesion that was treated by enucleation using an intraoral sagittal split osteotomy. This approach allowed for complete access and visualization of the cyst and displaced third molar and protection of the IAN with minimal surgical morbidity.
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