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Published on: January 13, 2023
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Coronectomy: An Alternative to Complicated Full-Bony Impacted Tooth Removal.
Gary Orentlicher1, Andrew Horowitz2
1Section Chief, Oral and Maxillofacial Surgery, White Plains Hospital, White Plains, New York; Private Practice in Oral, Maxillofacial, and Implant Surgery, Scarsdale, New York; Diplomate, American Board of Oral and Maxillofacial Surgery.
Compendium of Continuing Education in Dentistry (Jamesburg, N.J. : 1995)
|October 13, 2022
Summary
Impacted tooth removal is common, but risks nerve damage in the mandible. Coronectomy, a partial tooth removal, can reduce these risks for impacted third molars near the inferior alveolar nerve.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Surgery
- Neurosurgery
Background:
- Impacted teeth removal is a frequent outpatient surgical procedure.
- Proximity of mandibular third molars to the inferior alveolar nerve poses a risk of nerve injury.
- Nerve injury can result in temporary or permanent sensory disturbances.
Purpose of the Study:
- To evaluate the efficacy of intentional partial odontectomy (coronectomy) in mitigating risks associated with impacted mandibular third molar removal.
- To reduce the incidence of inferior alveolar nerve injury during impacted third molar extraction.
Main Methods:
- Surgical assessment of impacted mandibular third molars.
- Comparison of complication rates between conventional extraction and coronectomy.
- Evaluation of sensory disturbances post-procedure.
Main Results:
- Coronectomy significantly reduces the risk of inferior alveolar nerve injury compared to full extraction.
- The incidence of temporary and permanent sensory disturbances is lower with coronectomy.
- Coronectomy effectively preserves the nerve while removing the tooth crown.
Conclusions:
- Intentional partial odontectomy (coronectomy) is a viable surgical alternative for impacted mandibular third molars in close proximity to the inferior alveolar nerve.
- Coronectomy minimizes the risk of neurosensory complications.
- This technique offers a safer approach to managing high-risk impacted teeth.
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