Outcomes after mandibular third molar coronectomy

Lucas Borin Moura,Cristina Braga Xavier,Bibiana Dalsasso Velasques,Melissa Feres Damian,Bhárbara Marinho Barcellos

doi:10.1590/1981-86372020000063688

Abstract

ABSTRACT Coronectomy is an alternative technique to mandibular third molar removal to avoid inferior alveolar nerve impairment. It is indicated in cases where the dental roots are in close relationship with the nerve which results in a higher risk of damage and paresthesia. The coronectomy technique is considered a safe method to prevent inferior alveolar nerve injury, however it shows particular postoperative outcomes as migration and exposure of the retained roots, and possibility of additional intervention. The aim of this case series is to describe four different outcomes from coronectomy, in patients treated by the same protocol. The outcomes ranged from asymptomatic to migration, infection and root removal. Although the variety of outcomes, none of the patients showed inferior alveolar nerve impairment. Therefore, the main objective of coronectomy was reached.

Highlights

Coronectomy, described by Ecuyer & Debien in 1984, is an effective alternative technique to mandibular third molar removal, when the dental roots are in close relationship with the mandibular canal
Cone-Beam Computed Tomography (CBCT) is indicated to confirm the diagnosis since it allows the analysis of the real positioning of the dental roots to the mandibular canal, making possible to predict the possible risks of complications, such as paresthesia [5]
The aim of this study is to present a series of clinical cases in which inferior third molars underwent a coronectomy surgical procedure, focusing the possible postoperative outcomes related to this technique

Summary

Introduction

Coronectomy, described by Ecuyer & Debien in 1984, is an effective alternative technique to mandibular third molar removal, when the dental roots are in close relationship with the mandibular canal. Cone-Beam Computed Tomography (CBCT) is indicated to confirm the diagnosis since it allows the analysis of the real positioning of the dental roots to the mandibular canal, making possible to predict the possible risks of complications, such as paresthesia [5]. The possible complications of coronectomy include pain, edema, hemorrhage, infection, trismus and paresthesia, expected results after any surgical procedure of third molar removal. Coronectomy presents particular postoperative outcomes, such as migration of the remaining roots which is quite frequent – occurring between 14-81% of the cases, with an average migration of 2 to 4 mm. The migration can lead to exposure of the remaining fragments to the buccal mucosa, which will require a second intervention [1, 6,7,8]

Objectives

Discussion

Conclusion