Safety of coronectomy versus excision of wisdom teeth: A randomized controlled trial

• Published in: Oral surgery, oral medicine, oral pathology, oral radiology and endodontics Vol. 108; no. 6; pp. 821 - 827
• Main Authors: Leung, Yiu Yan, BDS, MDS, Cheung, Lim K., BDS, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.12.2009; Elsevier
• Subjects: Adult; Biological and medical sciences; Cranial Nerve Injuries - etiology; Cranial Nerve Injuries - prevention & control; Dentistry; Female; Humans; Intraoperative Complications - etiology; Intraoperative Complications - prevention & control; Mandibular Nerve - anatomy & histology; Medical sciences; Molar, Third - anatomy & histology; Molar, Third - diagnostic imaging; Molar, Third - surgery; Otorhinolaryngology. Stomatology; Radiography; Sensation Disorders - etiology; Sensation Disorders - prevention & control; Surgery; Tooth Crown - surgery; Tooth Extraction - adverse effects; Tooth Extraction - methods; Tooth Root - anatomy & histology; Tooth Root - diagnostic imaging; Tooth Root - surgery; Tooth, Impacted - complications; Tooth, Impacted - diagnostic imaging; Tooth, Impacted - surgery; Treatment Outcome; Trigeminal Nerve Injuries; Young Adult; Tooth root; Treatment; Exeresis; Surgery; Teeth; Tooth; Comparative study
• ISSN: 1079-2104; 1528-395X
• DOI: 10.1016/j.tripleo.2009.07.004

Objective The objective of this study was to compare the surgical complications and neurosensory disturbances of coronectomy and total excision of lower wisdom teeth with roots in close proximity to the inferior dental nerve (IDN). Study design A randomized controlled trial was conducted to compare the surgical complications and IDN deficit of coronectomy and total removal of wisdom teeth. Patients with specific radiographic signs of close proximity of wisdom teeth roots to the IDN were randomized. Results A total of 231 patients underwent surgery for 349 lower wisdom teeth (171 coronectomies, 178 controls); 16 coronectomies failed and were removed in total. Nine patients in the control group presented with IDN deficit, compared with 1 in coronectomy group ( P = .023). Pain and dry socket incidence was significantly lower in the coronectomy group, and there were no statistical differences in infection rate between the 2 groups. Reoperation of one coronectomy case was performed owing to persistent root exposure. Conclusion There are fewer complications in terms of IDN deficit, pain, and dry socket after coronectomy, but the infection rate is similar to that of total excision.