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[Temporal pattern of tooth root migration following coronectomy]
Ana Esther Pacheco1, Sarolta Gyulai1, Balázs Soós1
11 Pécsi Tudományegyetem, Általános Orvostudományi Kar, Klinikai Központ, Fogászati és Szájsebészeti Klinika, Arc-, Állcsont és Szájsebészeti Tanszék Pécs, Tüzér u. 1., 7633 Magyarország.
Introduction:
Injury to the inferior alveolar nerve is a potential complication during the removal of mandibular third molars, with a substantially increased risk when a direct anatomical relationship exists between the tooth roots and the mandibular canal. In such cases, coronectomy offers a surgical alternative that reduces the risk of nerve injury; however, the clinical relevance of postoperative root migration remains incompletely understood.
Objective:
This study analyzed the timing and extent of root migration after coronectomy, examined influencing factors, assessed radiological indications, and compared findings with existing literature.
Method:
This retrospective analysis was based on data from 73 coronectomies performed in 57 patients. During the study, panoramic X-ray images were examined with particular attention to radiological signs indicating an increased risk of inferior alveolar nerve injury, as well as combinations of these signs. The extent of root migration was determined using digital panoramic radiographs at follow-up examinations conducted at 1, 3, 6, 12, and 24 months. Additionally, the effects of age, anatomical factors related to impaction, tooth angulation, and the operator's level of professional experience were evaluated.
Results:
Root migration was detected in 90.4% of cases. Mean migration was 1.5 mm at 1 month, 2.4 mm at 3 months, 2.8 mm at 6 months, 3.2 mm at 12 months, and 3.5 mm at 24 months. The most pronounced migration occurred during the first 6 months postoperatively. A significant negative correlation was observed between patient age and the extent of migration. Horizontal, i.e., ramus space availability influenced migration, whereas tooth angulation and operator experience showed no significant effect.
Conclusion:
Coronectomy is an effective surgical option for patients at high risk of inferior alveolar nerve injury; nevertheless, the probability of subsequent intervention should be considered. With appropriate indication and follow-up, favorable long-term outcomes can be achieved. Orv Hetil. 2026; 167(12): 476-484.
