Abstract
The aim of this systematic review was to evaluate the clinical effectiveness of the surgical technique of coronectomy for third molars extraction in close proximity with the inferior alveolar nerve.A literature survey carried out through PubMed, SCOPUS and the Cochrane Library from inceptions to the last access in January 31, 2014, was performed to intercept randomised clinical trials, controlled clinical trials, prospective cohort studies or retrospective studies (with or without control group) that examined the clinical outcomes after coronectomy. The following variable were evaluated: inferior alveolar nerve injury, lingual nerve injury, postoperative adverse effects, pulp disease, root migration and rate of reoperation. Ten articles qualified for the final analysis. The successful coronectomies varied from a minimum of 61.7% to a maximum of 100%. Coronectomy was associated with a low incidence of complications in terms of inferior alveolar nerve injury (0%-9.5%), lingual nerve injury (0%-2%), postoperative pain (1.1%-41.9%) and swelling (4.6%), dry socket infection (2%-12%), infection rate (1%-9.5%) and pulp disease (0.9%). Migration of the retained roots seems to be a frequent occurrence (2%-85.3%).Coronectomy appears to be a safe procedure at least in the short term, with a reduced incidence of postoperative complications. Therefore, a coronectomy can be indicated for teeth that are very close to the inferior alveolar nerve. If a second operation is needed for the remnant roots, they can be removed with a low risk of paresthesia, because the roots are generally receded from the mandubular nerve.
Highlights
Extraction of an impacted mandibular third molar has the potential risk of causing temporary or permanent neurologic disturbances of the inferior alveolar nerve (IAN) [1]
All of the studies that examined the clinical outcomes after coronectomy technique through a literature survey carried out through PubMed, SCOPUS and the Cochrane Library from inceptions to the last access in January 31, 2014
Case reports, studies enrolling less than 10 subjects, comments, expert opinion, letters to the Editor, reviews, studies that analysed the same sample of a pre-existing study were excluded
Summary
Extraction of an impacted mandibular third molar has the potential risk of causing temporary or permanent neurologic disturbances of the inferior alveolar nerve (IAN) [1]. The incidence of IAN injury (IANI) reported in the literature ranges from 1.3% to 5.3% [2,3,4,5,6]. The risk of this complication depends mainly on the position of the impacted tooth in relation to the inferior alveolar canal before surgery [3]. The nerve may become transected by rotary instruments or during removal of a tooth whose root is grooved or perforated by the IAN.
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