Clinical Evaluations of Coronectomy (Intentional Partial Odontectomy) for Mandibular Third Molars Using Dental Computed Tomography: A Case-Control Study

Hatano, Yuko; Kurita, Kenichi; Kuroiwa, Yuichiro; Yuasa, Hidemichi; Ariji, Eiichiro

doi:10.1016/j.joms.2009.04.018

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 67, Issue 9 , Pages 1806-1814, September 2009

Clinical Evaluations of Coronectomy (Intentional Partial Odontectomy) for Mandibular Third Molars Using Dental Computed Tomography: A Case-Control Study

Yuko Hatano, DDS
- Fellow, First Department of Oral and Maxillofacial Surgery, Aichi Gakuin University School of Dentistry, Nagoya, Japan
- Address correspondence and reprint requests to Dr Hatano: First Department of Oral and Maxillofacial Surgery, Aichi Gakuin University School of Dentistry, 2-11 Suemori-dori Chikusa-ku, Nagoya 464-8651 Japan
Kenichi Kurita, DDS, PhD
- Professor and Chairman, First Department of Oral and Maxillofacial Surgery, Aichi Gakuin University School of Dentistry, Nagoya, Japan
Yuichiro Kuroiwa, DDS, PhD
- Assistant Professor, First Department of Oral and Maxillofacial Surgery, Aichi Gakuin University School of Dentistry, Nagoya, Japan
Hidemichi Yuasa, DDS, PhD
- Director, Department of Oral and Maxillofacial Surgery, Tokai Sangyo Iryodan Chuo Hospital, Tokai, Japan
Eiichiro Ariji, DDS, PhD
- Professor, Department of Oral and Maxillofacial Radiology, Aichi Gakuin University School of Dentistry, Nagoya, Japan

Purpose

Studies have suggested that coronectomy reduces the risk of inferior alveolar nerve injury (IANI) when a close relationship with the inferior alveolar canal is indicated on panoramic imaging. However, the relationship between the inferior alveolar canal and the root are unclear on panoramic imaging. Our aim was to compare coronectomy with traditional extraction for the treatment of mandibular third molars that had clear high IANI risks as evaluated by dental computed tomography.

Patients and Methods

We designed a case-control study of subjects with high-risk signs of IANI on panoramic images evaluated by dental computed tomography before enrollment. The 220 patients enrolled were assigned to extraction (control group, n = 118) or coronectomy (case group, n = 102).

Results

The mean follow-up time was 13 months in the extraction group and 13.5 months in the coronectomy group. Six IANIs (5%) were found in the extraction group. In the coronectomy group, 1 patient (1%) had symptoms of neurapraxia, which disappeared within 1 month. Four remaining roots had signs of postoperative infection, and the patients underwent extraction of the root. No nerve damage resulted in these patients after repeat extraction.

Conclusions

Coronectomy might reduce the risk of nerve injury for patients at true high risk of IANI as evaluated by dental computed tomography. A long-term postoperative review is needed to assess the incidence of root migration and the root extraction and infection rates after coronectomy.