Coronectomy

Radiograph of impacted wisdom tooth near nerve

Coronectomy is a dental surgical procedure that involves the removal of the crown of a tooth while leaving the roots intact. This procedure is typically performed on mandibular third molars, commonly known as wisdom teeth, when there is a high risk of damage to the inferior alveolar nerve during a full extraction.

Indications

Coronectomy is primarily indicated in cases where the roots of the mandibular third molar are in close proximity to the inferior alveolar nerve. This proximity increases the risk of nerve damage, which can result in complications such as paresthesia, anesthesia, or dysesthesia of the lower lip, chin, and teeth.

Procedure

The coronectomy procedure involves the following steps:

1. Administration of local anesthesia to numb the area.
2. Creation of a surgical flap to expose the crown of the tooth.
3. Sectioning and removal of the crown using a dental drill.
4. Smoothing and rounding off the remaining roots to ensure they are not sharp.
5. Closure of the surgical site with sutures.

Advantages

The primary advantage of a coronectomy is the reduced risk of nerve damage compared to a full extraction. By leaving the roots in place, the procedure minimizes the likelihood of injuring the inferior alveolar nerve.

Disadvantages and Complications

While coronectomy is generally considered safe, it is not without potential complications. These may include:

• Infection at the surgical site.
• Migration of the remaining roots, which may necessitate further surgical intervention.
• Incomplete removal of the crown, leading to the need for additional procedures.

Postoperative Care

Postoperative care following a coronectomy is similar to that of a standard tooth extraction. Patients are advised to:

• Maintain good oral hygiene to prevent infection.
• Avoid strenuous activities and follow a soft diet for a few days.
• Use prescribed pain medications and antibiotics as directed by the dentist or oral surgeon.

See Also

• Tooth extraction
• Wisdom tooth
• Inferior alveolar nerve
• Paresthesia