Somatosensory changes in Chinese patients after coronectomy vs. total extraction of mandibular third molar: a prospective study

• Published in: Clinical oral investigations Vol. 24; no. 9; pp. 3017 - 3028
• Main Authors: Yan, Zi-Yu, Yan, Xiao-Yan, Guo, Chuan-Bin, Xie, Qiu-Fei, Yang, Guang-Ju, Cui, Nian-Hui
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2020; Springer Nature B.V
• Subjects: Alveoli; Dentistry; Humans; Mandible; Mandible - surgery; Mandibular Nerve; Medicine; Molar, Third - surgery; Molars; Original Article; Pain; Pain perception; Patients; Prospective Studies; Surgery; Teeth; Tooth Crown; Tooth Extraction; Tooth, Impacted; Trigeminal Nerve Injuries - etiology; Coronectomy; Somatosensory function; Quantitative sensory testing; Inferior alveolar nerve injury
• ISSN: 1432-6981; 1436-3771
• DOI: 10.1007/s00784-019-03169-4

Objectives This study aimed to quantitatively compare the somatosensory function changes of inferior alveolar nerve (IAN) after mandibular third molar extraction with a surgery protocol of coronectomy, as opposed to the conventional method. Materials and methods Patients with a lower third molar directly contacting IAN were recruited and assigned either to a test group (coronectomy group) or a control group (conventional extraction). A standardized quantitative sensory testing (QST) battery was performed for four times: one week before surgery and the second, seventh, and 28th days after surgery. Z -scores and the loss/gain coding system were applied for each participant. Results A total of 140 molars (test group: n  = 91, control group: n  = 49) were enrolled. The sensitivity of the mechanical detection threshold (MDT) and pressure pain threshold (PPT) significantly increased after surgery more than before surgery in both groups ( P  ≤ 0.001). After the surgery, the sensitivities of the cold detection threshold (CDT), cold pain threshold (CPT), and heat pain threshold (HPT) were significantly higher in the test group than in the control group ( P  ≤ 0.027). The risk of IANI was significantly larger ( P  = 0.041) in the test group than in the control group. Conclusions QST was a sensitive way to detect somatosensory abnormalities even with no subjective complaint caused by surgery. Coronectomy had less influence on IAN function than conventional total extraction. Clinical relevance The somatosensory function changes after mandibular third molar extraction were quantitatively studied, and coronectomy was proved a reliable alternation to reduce IAN injury rate.