IADR Abstract Archives
Coronectomy Of Mandibular Third Molars. A Long-term Clinical Study.
Objectives: The aim of the study was to evaluate the long-term outcomes of coronectomy of mandibular third molars with intimate relation to the inferior alveolar nerve (IAN) with sensory disturbances of the IAN and root migration as the primary outcome variables.
Methods: In the period 2005-2015 a total of 231 coronectomies of the mandibular third molar were performed. The indication for a coronectomy in favour of complete removal of the mandibular third molar was based on a CBCT scan, which had indicated lack of bone between the root and the mandibular canal. After surgery, the patients were followed for a median of 5.8 years (range 1-12 years). Clinical variables were subjective and objective measures of sensory disturbances of the IAN, pathological findings in the region, and any postoperative infections or need for removal of the root complex. Radiological variables were root migration, bone formation and any pathological changes.
Results: Permanent IAN injury occured after 1.3% of the coronectomies whereas 3.9% had temporary disturbances. Migration of the root complex occurred in 97% cases mainly during the first year after the coronectomy. The overall postoperative complication rate was 16% of which infections counted for 11.7% and root removal for 3.5%. Infections were successfully treated with antibiotic therapy and none of the secondary operations with removal of the root complex led to IAN injury.
Conclusions: The evidence from this prospective study suggest that coronectomy is a safe procedure for mandibular third molars with an intimate relation to the IAN. The incidence of an IAN injury was 1.3%. Removal of the root complex was required in 3.5% of the cases and 11.7% had postoperative infections. At final follow-up all patients demonstrated healthy clinical conditions and no signs of continued root migration or late dental pulp sequelae.
Methods: In the period 2005-2015 a total of 231 coronectomies of the mandibular third molar were performed. The indication for a coronectomy in favour of complete removal of the mandibular third molar was based on a CBCT scan, which had indicated lack of bone between the root and the mandibular canal. After surgery, the patients were followed for a median of 5.8 years (range 1-12 years). Clinical variables were subjective and objective measures of sensory disturbances of the IAN, pathological findings in the region, and any postoperative infections or need for removal of the root complex. Radiological variables were root migration, bone formation and any pathological changes.
Results: Permanent IAN injury occured after 1.3% of the coronectomies whereas 3.9% had temporary disturbances. Migration of the root complex occurred in 97% cases mainly during the first year after the coronectomy. The overall postoperative complication rate was 16% of which infections counted for 11.7% and root removal for 3.5%. Infections were successfully treated with antibiotic therapy and none of the secondary operations with removal of the root complex led to IAN injury.
Conclusions: The evidence from this prospective study suggest that coronectomy is a safe procedure for mandibular third molars with an intimate relation to the IAN. The incidence of an IAN injury was 1.3%. Removal of the root complex was required in 3.5% of the cases and 11.7% had postoperative infections. At final follow-up all patients demonstrated healthy clinical conditions and no signs of continued root migration or late dental pulp sequelae.