Evaluation of the Outcomes of Coronectomy Procedure versus Surgical Extraction of Lower Third Molars Which Have a High Risk for Inferior Alveolar Nerve Injury: A Systematic Review.

Nedal Abu-Mostafa,Lulwah M Alrejaie,Fahad A Almutairi,Nourah A Alzahem,Maram M Alkodair,Ruba A Alajaji,Stefano Corbella

doi:10.1155/2021/9161606

Abstract

Results No study reported permanent inferior alveolar nerve injury (p-IANI) regarding coronectomy; however, transient inferior alveolar nerve injury (t-IANI) was reported in 0–2.20% of successful coronectomy and 0–8% of failed coronectomy. Postextraction t-IANI ranged from 0% to 16.66% while p-IANI from 0% to 3.63%. In 5 studies, root migration occurred in 2% to 85.3% of cases and the distance rate was 2.33–3.43 mm at 6 months postoperatively; then the migration gradually decreased and stopped at 12 months. Conclusion This systematic review revealed that coronectomy is an efficient alternative for the management of impacted 3rd M with a high risk of IANI. Patients who got antibiotics postcoronectomy procedures had lower infection rates than those who did not receive antibiotic therapy. We recommend further research on coronectomy with longer follow-up periods to assess the retained roots' long-term outcomes and to assess the effect of antibiotics administration on postcoronectomy infection rate. This systematic review is registered under number CRD42020198394.

Highlights

Mandibular third molars are the most commonly impacted teeth and the leading cause of various pathologies, from mild infection and inflammation to severe cystic lesions requiring surgical removal of the teeth [1]
As mandibular third molar roots are near the inferior alveolar canal, they have a high probability of causing neurosensory disturbances if the inferior alveolar nerve gets traumatized due to any treatment of the impacted tooth [1, 3]. ird molars close to the inferior alveolar canal must be extracted carefully
A systematic review of the published studies was conducted to evaluate the clinical outcomes of the coronectomy procedure compared to the surgical extraction of impacted third molars. is study was registered in the University Research Center, and the registration number was SRS/2020/13. e Institutional Review Board of the University approved the study, and the approval number was SRS/2020/13/195/184

Summary

Introduction

Mandibular third molars are the most commonly impacted teeth and the leading cause of various pathologies, from mild infection and inflammation to severe cystic lesions requiring surgical removal of the teeth [1]. More than 30% of the inferior alveolar nerve injuries (IANI) have been reported in confirmed cases of high-risk IAN involvement [5]. Apart from IAN’s involvement, several cases of damage to the lingual nerve during surgical removal of mandibular third molars have been reported [6]. Is technique is used to remove the crown portion of the third molar, keeping the roots intact and posing no harm or damage to the inferior alveolar nerve [7]. Surgical extraction of mandibular third molars (3rd M) may cause inferior alveolar nerve injury (IANI), whereas in coronectomy the crowns of 3rd M are removed, keeping the roots intact to avoid IANI. Is study aims to review the literature which evaluated coronectomy effectiveness as an alternative for surgical extraction of 3rd M that have a high risk of trauma to the inferior alveolar canal.

Methods

Results

Conclusion