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Impacted Mandibular Third Molar: Approaches and Current Perspectives in Surgical Therapy
Federica Di Spirito1, Pierpaolo Di Lorenzo2, Iman Rizki1
1Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Salerno, Italy.
Medicina (Kaunas, Lithuania)
|September 27, 2025
Summary
Coronectomy may reduce nerve injury risk during mandibular third molar removal, but it is not standardized. Careful informed consent is crucial due to potential medico-legal risks for practitioners.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Anesthesiology
- Surgical Complications
Background:
- Mandibular third molar surgery carries risks of neurological complications, including lingual nerve injury (LNI) and inferior alveolar nerve injury (IANI).
- Coronectomy, a conservative alternative, has been proposed to mitigate these neurological risks.
Purpose of the Study:
- To evaluate the advantages and limitations of coronectomy as an alternative to complete mandibular third molar extraction.
- To highlight the importance of informed consent in coronectomy procedures.
Main Methods:
- Review of existing literature on coronectomy and its comparison with complete extraction.
- Analysis of potential complications, particularly neurological injuries.
- Assessment of the standardization and medico-legal implications of coronectomy.
Main Results:
- Coronectomy appears to reduce the incidence of inferior alveolar nerve injury (IANI).
- However, coronectomy is currently a non-standardized procedure with several limitations.
- The procedure necessitates a thorough informed consent process due to potential practitioner medico-legal vulnerability.
Conclusions:
- Coronectomy offers potential benefits in reducing nerve damage during mandibular third molar surgery.
- The lack of standardization and associated medico-legal risks underscore the need for precise patient communication and consent.
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