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Published on: November 6, 2019
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Coronectomy in Lower Third Molar Surgery: A Systematic Review and Meta-Analysis
Fei Wu Kang1, Xin Rui Yuan2, Gong Cheng Li3
1Professor, Department of Oral and Maxillofacial Surgery, Stomatology Hospital Affiliated to Tongji University, Shanghai, China.
Summary
Coronectomy significantly reduces the risk of inferior alveolar nerve injury (IANI) and lingual nerve injury (LNI) compared to extraction for impacted mandibular third molars. While it lowers dry socket risk, coronectomy has a higher reintervention rate and specific failure rate.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Research
- Surgical Complications
Background:
- Impacted mandibular third molars often require surgical intervention.
- Inferior alveolar nerve injury (IANI) is a significant complication associated with third molar extraction.
- Coronectomy, a less invasive approach, is considered as an alternative to complete extraction.
Purpose of the Study:
- To systematically review and perform a meta-analysis comparing coronectomy and extraction of impacted mandibular third molars.
- To evaluate the incidence of inferior alveolar nerve injury (IANI) and other complications between the two surgical techniques.
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA guidelines.
- Comprehensive literature search across 5 databases for studies comparing coronectomy and extraction.
- Inclusion of 34 studies (24 cohort, 10 case-control) involving 7,115 wisdom teeth.
Main Results:
- Coronectomy significantly reduced the risk of IANI (RR: 0.1), LNI (RR: 0.2), and dry socket (RR: 0.4).
- No significant difference in postoperative infection rates was observed between coronectomy and extraction.
- Coronectomy showed a higher risk of surgical reintervention (3.63%), root exposure (2.66%), and a failure rate of 2.79%.
Conclusions:
- Coronectomy is a favorable option to reduce nerve injury and dry socket risk when removing high-risk mandibular third molars.
- Higher rates of secondary surgical intervention and specific failure rates are associated with coronectomy.
- Guided bone regeneration may mitigate residual root migration and reduce the need for secondary surgery.
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