Surgical Coronectomies: A Critical Review of Literature

Surgical Coronectomies: A critical review of literature

LT Robert Block DC, USN, CAPT Jesse Lee DC, USN, and CAPT Timothy Ackerman DC, USN

Introduction

Coronectomy was first proposed in 1984 and designed to avoid the risk of iatrogenic neurological injury to the inferior alveolar nerve .  IAN injury is a rare, but serious risk associated with removal of third molars, especially impacted third molars. The resulting sensory deficit may or may not be permanent and can have a significant effect on a patient’s quality of life.

An exhaustive literature review was performed and keys aspects of the clinical and radiographic examinations are presented that go into treatment planning for coronectomy.  This includes a discussion about the increased use of cone beam computed tomography in the decision making process.  A detailed description of accepted coronectomy techniques is outlined.  Risks, benefits, and alternative procedures are also discussed. Coronectomy significantly decreases risk of injury.  Clinicians trained to manage impacted teeth can easily perform the procedure and should consider it as a treatment option in patients that demonstrate high preoperative risk of IAN injury.

References

1. Long, H., Zhou, Y, Liao, L, Pyakurel, U., Wang, Y, and Lai, W.  Coronectomy vs. Total Removal for Third Molar Extraction: A Systematic Review. Journal of Dental Research 91(7) 2012; 659-665.

 

1. Patel, V., Sproat, C., Samani, M., Kwok, J., McGurk, M.  Unerupted Teeth Associated with Dentigerous Cysts and Treated with Coronectomy: mini case series. British Journal of Oral and Maxillofacial Surgery; 51(2013); 644-649.

 

1. Peterson’s Principles of Oral and Maxillofacial Surgery, 3^rd ed. (2012); Shelton, CT.

 

1. Monaco, G. DMD, de Santis, G. DMD, Gatto, M. R. A. PhD, Corinaldesi, G. MD, and Marchetti, C. MD, DDS.  Coronectomy: A Surgical Option for Impacted Third Molars in Close Proximity to the Inferior Alveolar Nerve.  Journal of the American Dental Association; 143(4) 2012; 363-369.

 

1. Vincent B. Ziccardi, DDS, MDa, John R. Zuniga, DMD, MS, PhD.  Nerve Injuries After Third Molar Removal. Oral Maxillofacial Surg Clin N Am 19 (2007) 105–115.

 

1. Gleeson, Clare, F. Patel, Vinod, Kwok, Jerry, and Sproat, Chris. Coronectomy Practice. Paper 1. Technique and Trouble-Shooting. British Journal of Oral and Maxillofacial Surgery; 50(2012), 739-744.

 

1. Kaori Shiratori, DDS, Assessment of the Shape of the Inferior Alveolar Canal as a Marker for Increased Risk of Injury to the Inferior Alveolar Nerve at Third Molar Surgery: A Prospective Study. J Oral Maxillofac Surg 71:2012-2019, 2013.

 

1. M. Anthony Pogrel, DDS, MD, FRCS, FACS. Partial Odontectomy. Oral Maxillofacial Surg Clin N Am 19 (2007) 85–91.

 

1. Cilasun, U., DDS, PhD, Yildirim, T., MD, Guzeldemir, E., DDS, PhD, Pektas, Z., DDS, PhD. Coronectomy in Patients with High Risk of Inferior Alveolar Nerve Injury Diagnosed by Computed Tomography. Journal of Oral Maxillofacial Surgery;  69(2011); 1557-1561.

 

1. Gleeson, Clare, F. Patel, Vinod, Kwok, Jerry, and Sproat, Chris. Coronectomy Practice. Paper 2: Complications and Long Term Management. British Journal of Oral and Maxillofacial Surgery; 51(2013); 347-352.

 

1. Leung, Y.Y. BDS, MDS, Cheung, L. K. BDS, PhD. Safety of Coronectomy Versus Excision of Wisdom Teeth: A Randomized Controlled Trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod (OOOOE) 2009; 108, 821-827.

 

1. Hatano, Y. DDS, Kurita, Kenichi, DDS, PhD, Kuroiwa, Y., DDS, PhD, Yuasa, H., DDS, PhD, and Ariji, E., DDS, PhD. Clinical Evaluations of Coronectomy (Intentional Partial Odontectomy) for Mandibular Third Molars Using Dental Computed Tomography: A Case-Control Study. Journal of the American Association of Oral and Maxillofacial Surgeons; 2009; 1806-1814.