Coronectomy versus total odontectomy of impacted lower third molars with close relation tothe inferior alveolar canal: An open clinical trial.
Keywords:Impacted third molar, Coronectomy, Inferior alveolar nerve, Odontectomy
Background and Objective: Coronectomy is the surgical removal of the crown part of a deeply impacted tooth to preserve the inferior alveolar nerve. This study aims to evaluate the consequences of coronectomy compared to complete surgical removal in patients with a high risk of inferior alveolar nerve injury.
Method: This clinical study is performed in the Department of Oral and Maxillofacial surgery, Dentistry College, Hawler Medical University. Forty patients (20-30 years old) enrolled in this study. All patients presented with mesioangular impacted mandibular third molar with intimate relation to the inferior alveolar nerve. The patients were subdivided randomly into two groups, each group consisting of twenty patients. Group A underwent conventional surgical removal of the lower third molar, while group B underwent coronoctomy. Postoperative sequels of pain, swelling, trismus, nerve injury, and root movement were recorded.
Results: The mean age (+ SD) of the studied sample was 25.5 + 4.1 years. Incidence of severe pain on day 1 was more in the study group than the control group but the difference was not significant (p = 0.091). There was a higher incidence of post-operative swelling in the control group than in the study group, but all the differences were not significant starting from day 1 to day 5. Regarding trismus All the differences between the two study groups were not significant.No case of nerve injury was recorded. Coronal root movement was recorded in 5 cases (25%). Data were analyzed using the Statistical Package for Social Sciences (SPSS, version 19).
Conclusion: Coronectomy is a predictable way to preserve IAN in cases with intimate relationship between the inferior alveolar nerve and symptomatic impacted wisdom tooth, where high risk of IAN injury is suspected.
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