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Partial odontectomy.

M Anthony Pogrel1

  • 1Department of Oral and Maxillofacial Surgery, University of California, San Francisco, Box 0440, Room C-522, 521 Parnassus Avenue, San Francisco, CA 94143-0440, USA. tony.pogrel@ucsf.edu

Oral and Maxillofacial Surgery Clinics of North America
|December 20, 2007
PubMed
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Coronectomy, a deliberate root retention technique, can protect the inferior alveolar nerve during lower third molar extraction when imaging shows close proximity. This method offers a potential solution to unpredictable nerve damage outcomes.

Area of Science:

  • Dentistry
  • Oral Surgery
  • Nerve Injury Prevention

Background:

  • Inferior alveolar nerve (IAN) involvement during lower third molar extraction presents clinical and medicolegal challenges.
  • IAN damage outcomes are unpredictable, with variable recovery rates, necessitating risk-mitigation strategies.

Purpose of the Study:

  • To evaluate coronectomy as a technique to reduce the risk of inferior alveolar nerve involvement during mandibular third molar surgery.
  • To highlight the utility of coronectomy in specific high-risk cases identified through advanced imaging.

Main Methods:

  • Review of coronectomy as a surgical option for mandibular third molar removal.
  • Consideration of imaging modalities like panoramic radiography and cone-beam CT (CBCT) to assess the relationship between third molar roots and the IAN.

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Main Results:

  • Coronectomy, or deliberate root retention, is a technique studied for protecting the IAN.
  • While not widely supported, it is indicated when imaging reveals an intimate relationship between the mandibular third molar roots and the IAN.

Conclusions:

  • Coronectomy is a viable consideration for mandibular third molar extraction when a high risk of IAN injury is identified.
  • This technique aims to minimize the unpredictable consequences of nerve damage during surgical procedures.