Intentional coronectomy as an alternative to avoid injuries to the lower alveolar nerve: Clinical case report
Keywords:Impacted tooth; Third molar; Oral surgery.
Introduction: Damage to the Inferior Alveolar Nerve (NAI) is a significant risk factor after removal of an impacted third molar. The absence of cortical bone between the dental root and the mandibular canal, as well as it’s constriction through which the tooth's root passes, are considered signs of high risk of nerve damage. Objective: To report a case of intentional coronaectomy of the lower right third molar, due to intimate contact with the mandibular canal. Patient, female, 19 years old, attended the Dental Specialties Center in Recife, indicated for third molar extraction. Panoramic radiography revealed horizontal impaction of tooth 48, crown contact with second molar roots, and apparent contact with the NAI. Cone beam computed tomography was requested, confirming a close relationship. The chosen approach was intentional coronaectomy and root burial. Conclusion: Literature proves that this technique significantly reduces injury to the inferior alveolar nerve, being an effective and safe alternative to avoid nerve complications.
Ali, A. S., Benton, J. A., & Yates, J. M. (2018). Risk of inferior alveolar nerve injury with coronectomy vs surgical extraction of mandibular third molars—A comparison of two techniques and review of the literature. Journal of oral rehabilitation, 45(3), 250-257.
Barcellos, B. M., Velasques, B. D., Moura, L. B., & Xavier, C. B. (2019). What are the parameters for reoperation in mandibular third molars submitted to coronectomy? A systematic review. Journal of Oral and Maxillofacial Surgery, 77(6), 1108-1115.
Barraclough, J., Power, A., & Pattni, A. (2017). Treatment planning for mandibular third molars. Dental update, 44(3), 221-228.
Bhola, S., & Pellatt, A. (2018). Coronectomies: assessment and treatment planning. British dental journal, 225(2), 125-12.
Biočanin, V., & Todorović, L. (2014). Coronectomy of two neighbouring ankylosed mandibular teeth: A case report. Vojnosanitetski pregled, 71(8), 777-779.
Cosola, S., Kim, Y. S., Park, Y. M., Giammarinaro, E., & Covani, U. (2020). Coronectomy of Mandibular Third Molar: Four Years of Follow-Up of 130 Cases. Medicina, 56(12), 654.
Crameri, M., & Kuttenberger, J. J. (2018). Application and evaluation of coronectomy in Switzerland. Swiss Dent J, 128(7-8), 582-586.
Espert, J. C., Martínez, S. P., Ballester, J. C., Oltra, D. P., & Diago, M. P. (2016). Coronectomy of impacted mandibular third molars: a meta-analysis and systematic review of the literature. Medicina oral, patología oral y cirugía bucal. Ed. inglesa, 21(4), 16.
Falci, S. G. M., Lima, T. C., Martins, C. C., Santos, C. R. R. D., & Pinheiro, M. L. P. (2017). Preemptive effect of dexamethasone in third-molar surgery: a meta-analysis. Anesthesia progress, 64(3), 136-143.
Fee, P. A., Wright, A., & Cunningham, C. (2016). Cone beam computed tomography in pre-surgical assessment of mandibular third molars. Evidence-based dentistry, 17(4), 117-118.
Hasegawa, T., Yamada, S. I., Ueda, N., Soutome, S., Funahara, M., Akashi, M., ... & Komori, T. (2018). Treatment modalities and risk factors associated with refractory neurosensory disturbances of the inferior alveolar nerve following oral surgery: a multicentre retrospective study. International journal of oral and maxillofacial surgery, 47(6), 794-801.
Lopes, G. B., & Freitas, J. B. (2013). Parestesia do nervo alveolar inferior após exodontia de terceiros molares. Arquivo Brasileiro de Odontologia, 9(2), 35-40.
Luo, Q., Diao, W., Luo, L., & Zhang, Y. (2018). Comparisons of the computed tomographic scan and panoramic radiography before mandibular third molar extraction surgery. Medical science monitor: international medical journal of experimental and clinical research, 24, 3340.
Mukherjee, S., Vikraman, B., & Duraiswamy Sankar, M. S. V. (2016). Evaluation of outcome following coronectomy for the management of mandibular third molars in close proximity to inferior alveolar nerve. Journal of clinical and diagnostic research: JCDR, 10(8), ZC57.
Oliveira, K. D. C. M. D. (2018). Eficácia da laserterapia e da laseracupuntura no tratamento de parestesia em pacientes submetidos à cirurgias de implantes e extração de terceiros molares inferiores (Doctoral dissertation, Universidade de São Paulo).
Pedersen, M. H., Bak, J., Matzen, L. H., Hartlev, J., Bindslev, J., Schou, S., & Nørholt, S. E. (2018). Coronectomy of mandibular third molars: a clinical and radiological study of 231 cases with a mean follow-up period of 5.7 years. International journal of oral and maxillofacial surgery, 47(12), 1596-1603.
Pitros, P., Jackson, I., & O’Connor, N. (2019). Coronectomy: a retrospective outcome study. Oral and maxillofacial surgery, 23(4), 453-458.
Ribeiro, A. C. F., dos Anjos Gonçalves, T., Carneiro, M. N., & Carneiro, P. M. A. (2021). O uso da laserterapia associada ao complexo B na prevenção de parestesia do nervo mandibular pós ressecção cirúrgica de ceratocisto odontogênico: relato de caso. Revista Eletrônica Acervo Saúde, 13(2), e5626-e5626.
Tachinami, H., Tomihara, K., Fujiwara, K., Nakamori, K., & Noguchi, M. (2017). Combined preoperative measurement of three inferior alveolar canal factors using computed tomography predicts the risk of inferior alveolar nerve injury during lower third molar extraction. International journal of oral and maxillofacial surgery, 46(11), 1479-1483.
Yeung, A. W. K., Wong, N. S. M., Bornstein, M. M., & Leung, Y. Y. (2018). Three-dimensional radiographic evaluation of root migration patterns 4–8.5 years after lower third molar coronectomy: a cone beam computed tomography study. International journal of oral and maxillofacial surgery, 47(9), 1145-1152.
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