Coronectomy Of Mandibular Third Molars Research Articles

INCIDENCE OF COMPLICATIONS AFTER THIRD MANDIBULAR MOLAR CORONECTOMY

Coronectomy is a technique that involves the removal of the crown of the third molar, leaving the root in place. It is recommended when the risks of complete extraction outweigh the benefits, especially in cases where there is a high risk of inferior alveolar nerve (IAN) injury. The success of coronectomy depends on adherence to the operating protocol, which is controlled by the oral sur­geon. The aim of this systematic review is to assess the incidence and nature of complications associated with the coronectomy of mandibular third molars. The systematic literature search was conducted according to PRISMA guidelines in MEDLINE (PubMed), and EMBASE (Sci­enceDirect) databases. A total of 287 titles were identi­fied. 9 studies met the final inclusion criteria. The results showed that coronectomy had a low incidence of IAN sensory disturbance, with 1.6% to 4.3% of cases expe­riencing such complications, while other studies recor­ded no cases of sensitivity loss. Infection and dry socket occurred in a small percentage of cases. Coronectomy is a safe and useful technique for treating impacted mandi­bular third molars. Similar or lower incidence of com­plications compared to those from extraction were seen. Further prospective homogenous randomized controlled clinical trials are necessary to evaluate the effectiveness of coronectomy in third mandibular molars.

Coronectomy of mandibular third molars: a systematic literature review and case studies.

Extraction of mandibular third molars (M3M) close to the inferior alveolar nerve (IAN) has a higher risk of neurological disturbance. This review aims to evaluate the evidence supporting the use of the coronectomy technique compared to complete extraction for such M3Ms. Case studies by a specialist oral and maxillofacial surgeon are included to illustrate clinical practice. Three databases (Cochrane Library, Embase, PubMed) were searched (November 2020). Additional articles were sought by hand searching the reference list of included articles. All studies published in English comparing outcomes of coronectomy with complete extraction with at least 50 subjects and 6months follow-up were included. Of the six included studies, five reported a lower rate of IAN disturbance after coronectomy compared with complete extraction. There were no reported cases of lingual nerve disturbance. Other outcomes of coronectomy such as pain, infection, alveolar osteitis were either similar or lower compared to complete extraction. There were high rates of root migration but low rates of exposure and reoperation. Follow-up protocols varied considerably. There is medium quality evidence to support the option of coronectomy for high risk M3M cases. Further studies to develop follow-up protocols to assist general dental practice is warranted.

Emergency admissions following coronectomy of mandibular third molars: a case series

Emergency admissions following coronectomy of mandibular third molars: a case series

A Review of 120 Coronectomy Root Retrievals

Coronectomy of mandibular third molars is a procedure aimed at reducing the risk of inferior dental nerve damage. The retention of roots has subsequent potential for becoming symptomatic and requiring root retrieval in the future. This sequela can lead to hesitation for patients and clinicians who may be considering coronectomy as a treatment option, and with the limited published evidence in this area, this is a reasonable concern. This study explores the events that may lead to root retrieval, including possible causes of symptoms and measures to increase success.

Migration of the root complex after coronectomy occurs within the first year after surgery: a 5-year radiographic analysis and protocol suggestion

Currently, there are no studies evaluating the radiographic follow-up protocol after coronectomy. This study aims to assess root migration after coronectomy of mandibular third molars in panoramic images taken 1, 3 and 5 years after surgery. This was a prospective cohort study of patients undergoing coronectomy of a mandibular third molar. The patients followed a 5-year follow-up regimen with panoramic examinations at 1, 3 and 5 years after the surgical intervention. Three observers assessed the panoramic images in a blinded randomized order to evaluate bone coverage; superimposition of the roots and the mandibular canal; and migratory changes of the roots. Descriptive statistics were used to describe changes. Furthermore, reproducibility among the observers was calculated. Sixty-two patients were included. Ingrowth of bone superior to the root complex during the first year was registered by all observers (observer 1: 100%; observer 2: 77.4%; and observer 3: 85.5%). Superimposition of the mandibular canal and the root complex in the panoramic images taken in the immediate postoperative period and after 1 year showed that 53.2% to 62.9% went from superimposition to no superimposition. Interobserver reproducibility was high. Migration of the root complex occurs primarily within the first year after coronectomy. Therefore, a routine radiographic follow-up after 1 year only is recommended.

Coronectomy of Mandibular Third Molars: Our Experience With 250 Consecutive Patients

Coronectomy of Mandibular Third Molars: Our Experience With 250 Consecutive Patients

Coronectomy of mandibular third molars: a clinical and radiological study of 231 cases with a mean follow-up period of 5.7 years

Coronectomy is a widely accepted treatment for mandibular third molars that are in close relationship to the mandibular canal. However, long-term studies on morbidity following this procedure have not been presented. The aim of this study was to examine the long-term morbidity after coronectomy, with sensory disturbances of the inferior alveolar nerve (IAN) and root migration as the primary outcome variables. A total of 231 mandibular third molar coronectomies were performed in 191 patients with a mean follow-up period of 5.7years (range 1–12years). The prevalence of IAN injury was 1.3%, and 3.5% of the retained roots were removed. None of the reoperations to remove the retained roots caused IAN impairment. Infections occurred in 11.7% of the cases and all were treated with antibiotics. Overall, 97% of the retained roots showed signs of migration and 65% showed signs of rotation. Therefore, coronectomy of the mandibular third molars with an intimate relationship to the mandibular canal seems to be a safe treatment modality with a good long-term prognosis.

Periodontal Healing Distally to Second Mandibular Molar After Third Molar Coronectomy

Coronectomy of mandibular third molars is a procedure that still raises a number of questions. The aim of the present study was to answer one unsolved question: the periodontal healing distal to the mandibular secondmolar after third molar coronectomy. A prospective cohort study was performed of 30 patients treated at the Unit of Oral and Maxillofacial Surgery of the Department of Biomedical and Neuromotor Science of the University of Bologna. The predictor variables were the probing pocket depth (PPD), the distance between the marginal crest (MC) and the bottom of the osseous defect (BOD), and the distance between the cementum enamel junction (CEJ) and the BOD. These clinical indexes were recorded on 3 points of the distal surface of secondmolar: the distobuccal (DB), distomedial (DM), and distolingual (DL) sites. The other variables evaluated included root migration and postoperative complications. The Wilcoxon test for paired data and Kendall's tau-b correlation coefficient was used to evaluate all variables. The significance level was set at P= .05. The cohort was composed of 30 patients with 34 high-risk mandibular third molars (9 men and 21 women), with a mean age of 28 ± 7years. At 9months, a statistically significant reduction in the PPD of 2 ± 3, 1 ± 2, and 2 ± 2mm and a statistically significant reduction in the MC-BOD distance of 4 ± 4, 4 ± 4, and 4 ± 5mm for the DB, DM, and DL sites, respectively, was observed (P= .001). Also, the intraoperative CEJ-BOD distance showed a statistically significant reduction for the DB, DM, and DL sites. After coronectomy, restoration of a clinical healthy periodontium distal to the secondmolar was observed. However, further studies are necessary to confirm these preliminary clinical results and to compare periodontal healing between coronectomy and complete extraction.

Coronectomy of impacted mandibular third molars: A meta-analysis and systematic review of the literature.

BackgroundCoronectomy is an alternative to complete removal of an impacted mandibular third molar. Most authors have recommended coronectomy to prevent damage to the inferior alveolar nerve during surgical extraction of lower third molars. The present study offers a systematic review and metaanalysis of the coronectomy technique.Material and MethodsA systematic review and meta-analysis was performed based on a PubMed and Cochrane databases search for articles published from 2014 and involving coronectomy of mandibular third molars located near the inferior alveolar nerve canal, with a minimum of 10 cases and a minimum follow-up period of 6 months. After application of the inclusion and exclusion criteria, a total of 12 articles were included in the study.Results and DiscussionCoronectomy results in significantly lesser loss of sensitivity of the inferior alveolar nerve and prevents the occurrence of dry socket. No statistically significant differences were observed in the incidence of pain and infection between coronectomy and complete surgical extraction. After coronectomy, the remaining tooth fragment migrates an average of 2 mm within two years.ConclusionsCoronectomy is indicated when the mandibular third molar is in contact with the inferior alveolar nerve and complete removal of the tooth may cause nerve damage. Key words:Coronectomy, included third molar, inferior alveolar nerve injury.

Coronectomy of mandibular third molars: A clinical protocol to avoid inferior alveolar nerve injury.

Coronectomy is a surgical procedure for the treatment of mandibular third molars in close proximity to the mandibular canal. Unfortunately, often the surgical protocol is not described step by step and it is difficult for the clinician to assess the key factors that are important for the success of this procedure. The aim of this paper is to propose and describe a standardized surgical protocol to improve the success of the technique. The treatment approach, for the most common types of third molars impaction is analysed. Each step of the surgical procedure is described in details and a new type of crown section is proposed. The presented protocol is proposed in order to define a clinical practitioner's guide that could help the surgeon who approaches coronectomy for the first times.

What Are the Types and Frequencies of Complications Associated With Mandibular Third Molar Coronectomy? A Follow-Up Study

Coronectomy has been proposed for impacted third molars in close proximity to the inferior alveolar nerve (IAN) to avoid neurologic injury. Immediate (up to 1 month) and late (2 to 36 months) postoperative complications were investigated. A prospective cohort study was performed on healthy patients treated in the dental clinic of the Department of Oral Surgery, University of Bologna. The predictor variables examined were experience of the surgeon (<10 vs ≥10 yr), length of surgery, type of mandibular third molar inclusion, and patient age. To assess the rate of postoperative complications, outcome variables were neurologic injuries, postoperative pain, swelling, fever, alveolitis, pulpitis, and root exposure. The success rate and need for a second surgery also were investigated. Univariate and bivariate descriptive statistics, Kaplan-Meier analysis, and Cox hazards modeling were performed to evaluate the variables. The study involved 94 healthy patients (mean age, 28.99 ± 8.9 yr; range, 17 to 56 yr; 37 men and 57 women) who had 116 third mandibular molars treated with coronectomy. During the 3-year follow-up period, 28 patients (29 coronectomy procedures) dropped out of the study. There was no case of neurologic injury to the inferior alveolar nerve (IAN) or to the lingual nerve (LN). In total, 30 complications were observed (25 within 1 month; 5 at 2 to 12 months). Surgeons with less than 10 years of training exposed patients to a greater risk of complications (hazard ratio = 2.069; 95% confidence interval, 1.004-4.263). An overall success rate of 74% at 6 months was estimated, and a second surgery was needed in 6% of cases. Of the retained roots analyzed, 80% showed postoperative root migration. In this study, coronectomy of mandibular third molars did not result in temporary or permanent injury to the IAN or LN. Coronectomy showed a low rate of postoperative complications. However, within the first year, a second surgery was needed in 6% of coronectomy procedures to remove migrated root fragments. Additional studies with larger patient samples are recommended to further investigate differences in postoperative complications in relation to patient age.

To retrieve or not to retrieve the coronectomy root – the clinical dilemma

Coronectomy of mandibular third molars is a well established technique that is going through a resurgence as it seems to reduce the risk of inferior dental nerve (IDN) injury. The reservation with the technique arises because of fear that the retained root will become infected and symptomatic over time. General dental practitioners will be responsible for the long-term review and care of these patients and, consequently, it is important that they are aware of the technique and its sequelae. Coronectomy of mandibular third molars to avoid nerve injury is becoming increasingly popular. It is important that general dental practitioners (GDPs) are aware of the immediate and later sequelae of treatment and the implication of the retained root.