Disimpaction of Mandibular third molar is a common minor oral surgical procedure which can be problematic with a significant incidence of iatrogenic complications. Causative factors for complications associated with disimpaction have been reported to be age, infection history, operator skills and type of impaction. The anatomic relation of third molar roots to the inferior alveolar nerve forms the most important factor amongst all the other factors.

 Traditionally periapical radiographs have been used diagnosis of the impacted teeth. The advantages of these radiographic technique are reduction in radiation and less magnification but one of the major disadvantages of periapical radiographs is Mandibular canal cannot be clearly identified. Also, the angulation of the radiograph can affect the position of the canal which can lead to misinterpretation of the apices of the impacted tooth in relation to Mandibular canal. However digital imaging, too, could not considerably help reduce the complications.

With the advent of this new technology and imaging system it is now possible to have an accurate knowledge about the regional anatomy. Preoperative CBCT and DICOM image files can help to obtain exact diagnosis, determine the proximity of Inferior Alveolar Nerve, amount of bone covering the third molar. The CBCT based DICOM images can be imported for virtual surgical planning where the area of interest can be segmented and the relations to anatomical structures can be viewed and accordingly the treatment plan for surgical extraction of impacted third molar can be planned with a guided model.

Thus the rationale of this study is to come up with methods to reduce the incidence of complications related to surgical extraction of impacted Mandibular third molar with virtually planned surgical guide for precise osteotomy and odontectomy for minimally invasive procedure and enhanced clinical outcomes.