Coronectomy: a long-term follow-up. Case series

Abstract

Aim  Coronectomy is an alternative technique for the removal of lower third molars in close proximity to the inferior alveolar nerve (IAN), minimizing the risk of nerve damage by retaining the roots in situ. This study aimed to evaluate the long-term outcomes and complications of coronectomy in four clinical cases.

Methods  Three healthy male patients (aged 28, 36, and 57 years) underwent four coronectomy procedures between 2010 and 2016. Preoperative panoramic radiographs and, in two cases, cone-beam computed tomography (CBCT) confirmed the proximity of the third molar roots to the IAN. Surgical protocols included standardized techniques, antibiotic prophylaxis, and postoperative follow-up with radiographic assessments at intervals ranging from 6 months to 10 years.

Results  Root migration was observed primarily within the first postoperative year, stabilizing thereafter. No cases exhibited root exposure, infection, or neurosensory deficits. The 28-year-old patient demonstrated the highest migration rate (5.65 mm), consistent with age-related trends reported in the literature.

Conclusion  Coronectomy is a viable and safe alternative for high-risk lower third molar extractions, significantly reducing the risk of IAN injury. Long-term follow-up confirmed minimal complications, though root migration remains a predictable occurrence, particularly in younger patients.

Keywords
Tooth extraction; Mandibular nerve; Molar, third; Tooth crown/surgery; Intraoperative complications