Inclusion Criteria:

• Patient who requires surgical removal of bilateral impacted M3.

  • Patient with impacted bilateral M3 which are sound.
  • Impacted bilateral M3 classified as Class I or II with Level A or B according to Pell and Gregory's classification.
  • Presence of M2 adjacent to the M3 to be extracted.
  • Patient aged 18 to 35 years old.
  • Patient with periodontal status of:
  • Basic Periodontal Score (BPE) 2 at lower right and lower left sextants.
  • Full mouth plaque score <30%.

Exclusion Criteria:

• Impacted M3 associated in the following conditions:

  • Fracture of angle of mandible.

  • Radiological evidence of cyst or tumour.

  • Incomplete root formation.

  • Acute pulpitis or severe pericoronitis that is not under-controlled.

  • Gross dental caries.

    • Retained roots of mandibular third molar with history of removal of unerupted/impacted M3.
    • Patient's age <18 years old or > 35 years old
    • M2 with periapical inflammation, periodontitis, distal caries or delayed or non-responsive pulp sensibility test to exclude tooth with perio-endo lesion.
    • Pregnant woman.
    • Patient on oral contraceptives.
    • Current or previous bisphosphonate therapy or history of radiotherapy to the jaws.
    • Active smoker.