Impacted Mandibular Third Molars Close to the Inferior Alveolar Nerve (IAN) Coronectomy: A Surgical Approach with Minimal Risk of Nerve Injury.

Abstract

Aims and objectives: To evaluate the efficacy of treatment following coronectomy on mandibular third molars with inferior alveolar nerve (IAN) involvement.

Methods: A cross-sectional descriptive analysis was done on the mandibular third molars of 37 people (≥ 18 years old, 28 males, and 9 females) who needed a coronectomy and had a confirmed diagnosis of IAN in groups I, II, and III according to the classification of Q. Luo 2018, as found by CBCT.

Result: The most prevalent indication in panoramic photographs was an interruption of the canal sign's white line (45.9%). The coronectomy approach had a success rate of 100%. There were statistically significant differences in the degree of vertical and horizontal face swelling, as well as mouth opening, between the second and third postoperative days. No incidences of paresthesia were reported after surgery. The root migrated the most in the first 3 months following surgery, measuring 2.43 ± 1.08 mm. At 6 months following surgery, the root migrated by 2.95 ± 1.27 mm. At 9 months following surgery, the root migrated 3.04 ± 1.19 mm from its initial location.

Conclusion: The risk of complications after a coronectomy seems to be inadequate, at least in the immediate aftermath of the operations. Coronectomy may be required for molars that are close to the IAN. Due to the roots often receding from the IAN, a second procedure to remove the remaining roots is typically performed with minimal risk of paresthesia.