Impacted Supernumerary Tooth Extraction Using an In‐House‐Manufactured 3D Guide and a Trephine Bur for Osteotomy: A Case Report

Introduction: Supernumeraries are teeth that exceed the normal dental formula. They may be asymptomatic and diagnosed incidentally through radiographs or associated with potential complications. The preferred treatment is surgical extraction. Case report: This case describes the surgical extraction of a supernumerary tooth impacted on the lingual aspect of the mandible, located between the roots of the left premolars, near the mental nerve emergence, using an in-house-manufactured 3D guide and trephine bur for osteotomy. The procedure involved a surgical template designed using computer-aided design (CAD) and manufactured in-house with a 3D printer to guide a trephine bur during osteotomy. Surgery, carried out under local anesthesia, included incision and elevation of a mucoperiosteal flap, guided osteotomy with a trephine bur, bone trapdoor removal, super- numerary extraction, flap repositioning, and suturing. No complications were reported. Guided surgery is particularly helpful in cases of deep impaction, limited visibility, and challenging instrument access, such as a lingual approach in the mandibular premolar region.