Coronectomy: a retrospective outcome study

Oral Maxillofac Surg. 2019 Dec;23(4):453-458. doi: 10.1007/s10006-019-00794-x. Epub 2019 Aug 27.

Abstract

Purpose: Inferior alveolar nerve (IAN) injury is reported as a complication following surgical removal of lower third molars. In cases where the IAN is intimately related to the roots of the tooth, coronectomy may be performed as an alternative. The objectives of this study were to record operative indications for coronectomy and assess the short- and long-term post-operative outcomes following coronectomy.

Methods: This retrospective study included patients (19-95 years old) that had coronectomies carried out in the Edinburgh Dental Institute and Chalmers Dental Centre within the last 10 years. The patients were invited by letter to attend a review appointment. High-risk radiographic signs and short- (≤ 3 months) and long-term complications (> 3 months) were recorded.

Results: A total of 124 patients were invited to participate and a total 28 patients returned for review. From the rest of the patients, data was extracted from their dental records. IAN injury was reported in 5 cases (4.3%) as a short-term complication and in 2 cases (3.5%) as a long-term complication. One patient presented with eruption of roots at the review appointment 7 years following surgery. In this study, 'very' long-term complications were recorded as the 28 patients that returned for a review, were seen on an average of 4.8 years post-operation.

Conclusions: Coronectomy is a relatively safe technique for preservation of the IAN. However, prospective large scale research is needed to more accurately report on the prevalence of short- and long-term complications.

Keywords: Coronectomy; Inferior alveolar nerve (IAN) injury; Surgical extraction; Third lower molars.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Humans
  • Mandible
  • Mandibular Nerve
  • Middle Aged
  • Molar, Third
  • Outcome Assessment, Health Care
  • Prospective Studies
  • Retrospective Studies
  • Tooth Crown
  • Tooth Extraction
  • Tooth, Impacted*
  • Trigeminal Nerve Injuries*
  • Young Adult