Virtual Surgical Planning and Piezoelectric Instrumentation in the Management of a Symptomatic Mandibular First Molar Encasing the Inferior Alveolar Nerve: A Case Report

ABSTRACT Aim This case report aims to describe the successful virtual planning and surgical removal of a first mandibular molar with root perforation by the inferior alveolar nerve (IAN). Materials and Methods A 61‐year‐old male presented with a symptomatic ectopic molar, complicated by entrapment of the IAN within the roots. Outlined is the novel approach involved in its surgical removal, utilising three‐dimensional virtual surgical planning, custom surgical guides and piezoelectric instrumentation. Results Post‐operative radiographs and clinical follow‐up demonstrated successful removal of the ectopic symptomatic molar with uneventful wound healing and resolving mild neuropraxia at the 6‐month review. Conclusion The incidence of first mandibular molars with root perforation by the IAN is particularly uncommon and has been seldom documented in the literature. Presented is a case outlining the surgical planning and advanced techniques involved in their surgical removal. Successful interdisciplinary collaboration allowed for favourable surgical outcomes and the prevention of iatrogenic damage.