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Coronectomy of third molar: a reduced risk technique for inferior alveolar nerve damage

From Volume 38, Issue 4, May 2011 | Pages 267-276

Authors

Chkoura Ahmed

Resident in Oral Surgery, Faculty of Dentistry, Rabat, Morocco

Articles by Chkoura Ahmed

El Wady Wafae

Professor and Chief of the Division of Oral Surgery, Faculty of Dentistry, Rabat, Morocco

Articles by El Wady Wafae

Taleb Bouchra

Professor of Oral Surgery, Faculty of Dentistry, Rabat, Morocco

Articles by Taleb Bouchra

Abstract

Causing damage to the inferior alveolar nerve (IAN) when extracting lower third molars is due to the intimate relationship between the nerve and the roots of the teeth. When the proximity radiologic markers between the IAN and the root of the third molars are present, the technique of coronectomy can be proposed as an alternative to extraction to minimize the risk of nerve injury, with minimal complications.

Clinical Relevance: Nerve injury after the extraction of the mandibular third molar is a serious complication. The technique of coronectomy can be proposed to minimize the risk.

Article

Operations on mandibular third molars are common and are complicated by temporary injury to the inferior alveolar nerve in up to 8% and permanent injury in under 1% of cases.1,2 Risk factors include advanced age1 and difficult operating conditions,3 but the most important one is the proximity of the third molar to the mandibular canal.4 Coronectomy (Figure 1) avoids the inferior alveolar nerve by ensuring retention of the roots when they are close to the canal.5 This has been illustrated in Cases 1 (Figures 2–5), 2 (Figures 6, 7) and 3 (Figures 8–11).

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