What Are the Parameters for Reoperation in Mandibular Third Molars Submitted to Coronectomy? A Systematic Review

Coronectomy is an alternative technique to conventional lower third molar removal that aims to decrease inferior alveolar nerve impairment. The purpose of this study was to identify factors associated with reoperation after mandibular third molar coronectomy.

This systematic review sought scientific articles in the MEDLINE (PubMed), Scopus (Elsevier), and Cochrane Library databases. Studies that evaluated reoperation after coronectomy and reported a minimum follow-up of 6 months were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) quality assessment of the included articles was performed, and the following data were analyzed: demographic characteristics, reason for reoperation, and time from coronectomy to reoperation. The data were subjected to descriptive analysis.

The initial search yielded 362 studies and 15 were included in the final review. In total, 1,664 patients and 2,062 teeth underwent coronectomy. Most patients were women (60.58%). The follow-up period for reoperation ranged from 6 months to 10 years and the mean time until the second procedure was 10.4 months (quartile 1, 3; quartile 3, 8.5). Only 105 teeth (5.1%) were reoperated on. The main reasons for reoperation were root exposure (53.33%), infection (10.47%), pain (9.52%), and enamel residual (9.52%). In the PRISMA quality evaluation, only 1 article presented a low risk of bias.

Reoperation after mandibular third molar coronectomy was low (cases, ∼5%); the main reasons for reoperation were residual root exposure and symptomatology. Owing to the possibility of late exposure or symptomatology, a follow-up longer than 6 months is recommended until root exposure or the end of the migration process.