Course Karma

Bloopers at the end...

This is based on a lecture I gave at the Course Karma Summit that got a surprisingly strong response.

It’s the inspiration behind MAP: Mentorship and Accountability Program.

The idea is simple:

Stop trying to change everything at once.

Focus on the week ahead of you.

Learn something.
Apply something.
Build momentum.

That’s how you actually get better.

Not by collecting more information, but by turning what you already know into action.

That’s what MAP is built for.

Don’t worry we’ve got you covered 💪. Great to see such a high turnout but we were caught a bit unprepared. Zoom room capacity maxed out 👀

Free Replay available till Sunday!

Link in bio for Third Molar Masterclass

Plz let us know if you are finding these guides helpful.. Or if we should go back to posting cute selfies 😉🍑

Horizontal impactions demand a very deliberate flow once adequate exposure is achieved.

First 👉 the crown is separated from the roots with a vertical crown–root section. The cut is kept precise to avoid creating a crown segment that is wider apically and difficult to deliver.

*If the crown cannot be removed as a single unit 👉 it is further divided into mesial and distal halves, allowing each segment to be removed with less resistance and without unnecessary bone removal.

With the crown out of the way 👉 attention shifts to the roots. Because the previous step already defines the mesial–distal split, purchase points are placed on the superior aspect of the upper root first, followed by removal of the lower root. Elevation is controlled, methodical, and space-driven rather than force-driven.

Throughout every step, the bur cut is kept strictly within tooth structure to protect the lingual tissues and the inferior alveolar canal.

Hungry to learn more?

Join Dr. Ben Johnson & Dr. Sohaib Soliman on May 6 for a Free live Masterclass on Third Molar extractions.

👉 Link in bio.

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Considered the most difficult lower third molar angulation for removal 👀

Your heart rate might pick up a little when you see this on the radiograph.

Comment “molar” and I’ll DM you a link to register for the free Masterclass on May 6th.

Distoangular lower third molars have that effect, not because of how much bone is covering them, but because the path of withdrawal is into the vertical ramus.

After adequate buccal and distal troughing to below the cervical line, we prefer to attempt elevation first to assess root mobility. This step is especially helpful in older patients where bone elasticity is reduced. If an unfavorable split happens during sectioning, the remaining segments are already mobile and easier to manage.

From here, the guiding principle is: create space by reducing tooth structure, not by removing more mandibular bone.

Two main sectioning patterns are used:

Distal crown reduction first 👉 remove the portion of the crown locked under the distal bone, create a mesial purchase point, and elevate. (If resistance persists, subdivide the remaining segment rather than removing additional bone).

Crown-then-roots sectioning 👉 perform a horizontal odontotomy to separate and remove the entire crown, then section the roots through the furcation and deliver the distal root first, followed by the mesial.

Clinical tip:
When separating roots, direct the bur from the mesial aspect of the remaining root mass toward the furcation in a diagonal path. This preserves buccal bone, reduces surgical trauma, and allows easier root separation.

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