Coronectomy versus total odontectomy of impacted lower third molars with close relation tothe inferior alveolar canal: An open clinical trial.

Authors

  • Hundren Muhammad Department of Oral and Maxillofacial Surgery, College of Dentistry, Hawler Medical University, Erbil, Iraq.
  • Rozh Mumtaz Department of Oral and Maxillofacial Surgery, College of Dentistry, Hawler Medical University, Erbil, Iraq.
  • Dilman Najmaddin Department of Oral and Maxillofacial Surgery, College of Dentistry, Hawler Medical University, Erbil, Iraq.
  • Omed Ikram Department of Oral and Maxillofacial Surgery, College of Dentistry, Hawler Medical University, Erbil, Iraq.

DOI:

https://doi.org/10.15218/edj.2023.04

Keywords:

Impacted third molar, Coronectomy, Inferior alveolar nerve, Odontectomy

Abstract

Background and Objective: Coronectomy is the surgical removal of the crown part of a deeply impacted tooth to preserve the inferior alveolar nerve. This study aims to evaluate the consequences of coronectomy compared to complete surgical removal in patients with a high risk of inferior alveolar nerve injury.

Method: This clinical study is performed in the Department of Oral and Maxillofacial surgery, Dentistry College, Hawler Medical University. Forty patients (20-30 years old) enrolled in this study. All patients presented with mesioangular impacted mandibular third molar with intimate relation to the inferior alveolar nerve.  The patients were subdivided randomly into two groups, each group consisting of twenty patients. Group A underwent conventional surgical removal of the lower third molar, while group B underwent coronoctomy. Postoperative sequels of pain, swelling, trismus, nerve injury, and root movement were recorded.

Results: The mean age (+ SD) of the studied sample was 25.5 + 4.1 years. Incidence of severe pain on day 1 was more in the study group than the control group but the difference was not significant (p = 0.091). There was a higher incidence of post-operative swelling in the control group than in the study group, but all the differences were not significant starting from day 1 to day 5. Regarding trismus All the differences between the two study groups were not significant.No case of nerve injury was recorded. Coronal root movement was recorded in 5 cases (25%).  Data were analyzed using the Statistical Package for Social Sciences (SPSS, version 19).

Conclusion:  Coronectomy is a predictable way to preserve IAN in cases with intimate relationship between the inferior alveolar nerve and symptomatic impacted wisdom tooth, where high risk of IAN injury is suspected.

References

Libersa P, Savignat M, Tonnel A. Neurosensory disturbances of the inferior alveolar nerve: a retrospective study of complaints in a 10-year period.Oral Maxillofac Surg.;65:1486–9. doi:.1016/j.joms.2007.03.023.

Bataineh AB. Sensory nerve impairment following mandibular third molar surgery.J Oral Maxillofac Surg.;59:1012–7. doi:.1053/joms.2001.25827.

Bui CH, Seldin EB, Dodson TB. Types, frequencies, and risk factors for complications after third molar extraction.Oral Maxillofac Surg.;61:1379–89. doi:.1016/j.joms.2003;04.001.

-Yiu Yan Leung and Lim K. Cheung. Safety of coronectomy versus excision of wisdom teeth: A randomized controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 108:821-827.

-R. Frafjord &T. Renton A review of coronectomy. Oral Surgery j. 2011;752-2471

-Shahrokh C. Bagheri, Roger A. Meyer. Management of Mandibular Nerve Injuries from Dental Implants,Atlas Oral Maxillofacial Surg Clin N Am 19. 2011:47–61

-Momen A. Atieh MScDiagnostic Accuracy of Panoramic Radiography in Determining Relationshi between Inferior Alveolar Nerve and Mandibular Third Molar.J Oral Maxillofac Surg.2010;68:74-82, 2010.

-Renton T, Hankins M, Sproate C, et al: A randomised controlled clinical trial to compare the incidence of injury to the inferior alveolar nerve as a result of coronectomy and removal of mandibular third molars. Br J Oral Maxillofac Surg.2005;43:7.

-Monaco G, de Santis G, Gatto MR, Corinaldesi G, Marchetti C. Coronectomy: a surgical option for impacted third molars in close proximity to the inferior alveolar nerve. J Am Dent Assoc. 2012; 143: 363-369.

-Long H, Zhou Y, Liao L, Pyakurel U, Wang Y, Lai W. Coronec tomy vs. total removal for third molar extraction: a systematic re view. J Dent Res. 2012;91:659-65

-Giuseppe Monaco, DMD, Giselle De Santis, DMD,y Giuseppe Pulpito, DMD,zMaria Rosaria Antonella Gatto, PhD,x Elisabetta Vignudelli, DMD,kand Claudio Marchetti, MD, DDS.What Are the Types and Frequenciesof Complications Associated WithMandibular Third Molar Coronectomy?A Follow-Up Study . American Association of Oral and MaxillofacialSurgeons.2015;0278-2391.

Benoît Lenfant,Haese,KimakheLesclous. Third mandibular molar coronectomy: a way to prevent iatrogenic inferior alveolar nerve injuries—an systematic review. J Oral Med Oral Surg.2018:93-99. DOI: https://doi.org/10.1051/mbcb/2017036

-Leung YY, Cheung KY :Root migration pattern after third molar coronectomy: a long-term analysis. nt J Oral Maxillofac Surg. 2018;47(6):802-808.

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Published

2023-06-30

How to Cite

1.
Muhammad H, Mumtaz R, Najmaddin D, Ikram O. Coronectomy versus total odontectomy of impacted lower third molars with close relation tothe inferior alveolar canal: An open clinical trial. EDJ [Internet]. 2023 Jun. 30 [cited 2024 Jul. 25];6(1):32-8. Available from: https://edj.hmu.edu.krd/index.php/journal/article/view/216

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