Features and advantages of performing the coronectomy procedure as an alternative to complete extraction of the mandibular third molars: a literature review
DOI:
https://doi.org/10.32782/2786-7676/2023.1.02Keywords:
coronectomy, lower third molars, literature review.Abstract
The article presents data on the indications, contraindications, advantages and disadvantages of the coronectomy procedure of third mandibular molars as an alternative to their complete extraction, based on the results of previously conducted studies of a systematic and metaanalytic nature, retrospective studies with a long monitoring time, and randomized controlled studies. Systematized data is based on the results of the analysis of 23 publications included in the research sample, among which 10 systematic reviews, 6 literature reviews, 4 prospective cohort studies, 1 clinical case series presentation, 1 randomized controlled trial, 1 clinical trial. According to the retrospective analysis of the literature, indications for the coronectomy procedure include: X-ray-confirmed proximity of the mandibular third molar to the canal of the inferior alveolar nerve; signs of narrowing or a loop-like turn of the mandibular canal; darkening of the area at the apical third of the mandibular third molars and discontinuity of the contour of the inferior alveolar nerve canal; discontinuity of the lingual cortical bone; healthy state of third molars without signs of carious lesions, periodontal or periapical pathologies. It has been established that the coronectomy procedure of the mandibular third molars can be used as an effective alternative to the complete extraction of third molars with sign of dystopia or retention in patients with an increased risk of inferior alveolar nerve damage during the operation, under the conditions of its implementation in accordance with specific clinical indications, while taking into account all the features of the surgical intervention procedure and considering specific conditions of the clinical situation. Partial odontectomy clearly minimizes the risk of developing neurosensory complications compare to complete removal of the mandibular third molars. The frequency of repeated interventions after the coronectomy procedure, aimed at treating the corresponding consequences of this surgical approach, remains relatively small, however, patients after the partial odontectomy of the mandibular third molars require monitoring lasting more than 6 months.
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