Clinical and dental computed tomographic evaluation 1 year after coronectomy

Area of Science:

• Dentistry
• Oral Surgery
• Radiology

Background:

• Coronectomy is an alternative to complete extraction for mandibular third molars when the root apex is close to the inferior alveolar nerve.
• While coronectomy's efficacy is known, long-term outcomes of retained root fragments are less understood.
• This study evaluates the 1-year postoperative prognosis of coronectomy sites using clinical and advanced imaging.

Purpose of the Study:

• To clinically and radiographically assess the 1-year postoperative status of retained root fragments after coronectomy.
• To determine the incidence of complications such as periapical lesions or inflammation around retained roots.
• To evaluate bone coverage and tissue health at coronectomy sites.

Main Methods:

• A retrospective analysis of 101 patients (116 teeth) who underwent coronectomy between March 2006 and December 2009.
• Patients were recalled for a 1-year follow-up including clinical examination (palpation, macroscopic inspection) and dental computed tomographic (CT) imaging.
• CT imaging was used to assess bone coverage and the presence of periapical lesions.

Main Results:

• Over 99.2% of retained roots were asymptomatic, covered by bone, and associated with healthy distal soft tissue.
• One case (0.8%) showed root eruption into the oral cavity without associated inflammation.
• No periapical lesions indicative of pulp necrosis were detected in any of the 116 retained root apices.

Conclusions:

• Coronectomy demonstrates a safe postoperative course at the 1-year follow-up.
• Bone coverage and lack of periapical lesions in the vast majority of cases indicate successful root fragment management.
• The findings support coronectomy as a viable option with favorable short-term outcomes when indicated.