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Scripta Scientifica Medicinae Dentalis

Alternative method for surgical treatment of a semi-impacted lower third molar – a case report

Georgi Papanchev, Madlen Ali

Abstract

INTRODUCTION: Injuries to nerves associated with third molar surgery can pose a challenging complication, resulting in sensory disruptions, chronic pain, and adverse psychological effects for the affected individual. It is crucial to prioritize the preservation of the nerve from injuries during third molar surgery. Coronectomy, serving as an alternative surgical approach in cases with a high damage risk to the inferior alveolar nerve (IAN), has demonstrated long-term effectiveness and safety.

AIM: This study aims to present the application of an alternative method for surgical treatment of high-risk semi-impacted lower third molar with an eight-month follow-up.

MATERIALS AND METHODS: The following case is presented: a 35-year-old patient, with periodic complaints of pain, discomfort and swelling in the area of tooth 38. Objective clinical criteria referred to pericoronaritis due to semi-impacted left wisdom tooth. Preoperative cone-beam computed tomography (CBCT) scan revealed passage of the IAN between the roots of tooth 38. Extraction of this tooth carried a risk of nerve damage, and a coronectomy was decided upon.

RESULTS: Eight-month follow-up showed new bone formation above the remnant roots, without any periapical lesions around them. Results show that performing a coronectomy on wisdom teeth is a suitable and secure method, especially when radiographic evidence reveals a close proximity between the IAN and the tooth roots.

CONCLUSION: Coronectomy is a third-molar surgical strategy that involves removing only the crown of the wisdom tooth, while preserving the roots intact. It has been demonstrated that coronectomy effectively prevents IAN injury, making it a safe long-term approach.


Keywords

coronectomy, third molar surgery, alternative methods, IAN injury

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References

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DOI: http://dx.doi.org/10.14748/ssmd.v10i1.9544

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About The Authors

Georgi Papanchev
Medical University of Varna
Bulgaria

Department of Oral Surgery, Faculty of Dental Medicine

Madlen Ali
https://orcid.org/0000-0002-7395-0520
Medical University of Varna
Bulgaria

Department of Oral Surgery, Faculty of Dental Medicine

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