Coronectomy of the mandibular third molar: Respect for the inferior alveolar nerve

• Published in: Journal of cranio-maxillo-facial surgery 2016-05, Vol.44 (5), p.616-621
• Main Authors: Kouwenberg, A.J, Stroy, L.P.P, Rijt, E.d.Vree- v.d, Mensink, G, Gooris, P.J.J
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Child; Coronectomy; Decapitation; Dentistry; Female; Humans; Inferior alveolar nerve; Intraoperative Complications - prevention & control; Male; Mandible; Mandibular canal; Middle Aged; Molar, Third - diagnostic imaging; Molar, Third - surgery; Prospective Studies; Radiography, Panoramic; Surgery; Third molar; Tooth Crown - surgery; Tooth, Impacted - surgery; Trigeminal Nerve Injuries - prevention & control; Wisdom tooth; Young Adult
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2016.01.025

Abstract The aim of this study was to evaluate the outcomes of coronectomy as an alternative surgical procedure to complete removal of the impacted mandibular third molar in patients with a suspected close relationship between the tooth root(s) and the mandibular canal. A total of 151 patients underwent coronectomy and were followed up with clinical examinations and panoramic radiographs for a minimum of 6 months after surgery. None of the patients exhibited inferior alveolar nerve injury. Eruption of the retained root(s) was more frequent in younger patients (18–35 years). Thirty-six patients (23.8%) exhibited insufficient growth of new bone in the alveolar defect, and 11.3% required a second surgical procedure to remove the root remnant(s). Our results indicate that coronectomy can be a reliable alternative to complete removal of the impacted mandibular third molar in patients exhibiting an increased risk of damage to the inferior alveolar nerve on panoramic radiographs.