Coronectomy as an alternative technique to complete extraction of mandibular third molars with risk of nerve injury.

IF 2.2 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
L Rico-Barroso, M Barroso-Medel, J Gutiérrez-Pérez, M Serrera-Figallo, D Torres-Lagares
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Abstract

Background: Extraction of mandibular third molars (MTM) is one of the most frequent surgical procedures in Oral Surgery. This intervention is not without risks, as one of the most common is an injury of the inferior alveolar nerve (IAN). The main objective of this systematic review is to compare the coronectomy technique with conventional extraction of MTM with a high risk of injury to the IAN, thus determining whether coronectomy is an effective surgical alternative in preventing nerve injuries.

Material and methods: A bibliographical search was conducted in October 2024 in the Pub-Med and Cochrane-Database databases, and 211 studies were obtained. Finally, 16 studies were included in the systematic review, with a total sample of 2551 patients. 2280 coronectomy procedures and 841 extractions were performed.

Results: 6.22% of the coronectomies performed were unsuccessful. The incidence of IAN injury was 6.53% in the extraction group, while in the coronectomy group, it was only 0.56%. Permanent IAN injury was 1.18% and 0.13%, respectively. The most common complication in both groups was postoperative pain, with similar results, 15.69% in the extraction group vs. 14.21% in the coronectomy group. Lingual nerve injury was infrequent and transient in both groups, affecting 0.12% of extractions and 0.26% of coronectomies. The complication with the highest incidence in the coronectomy group was root migration, mainly during the first 6 months.

Conclusions: Coronectomy is a safe and effective alternative technique for the management of MTM with a high risk of IAN injury.

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冠状切除术是一种有神经损伤风险的下颌第三磨牙完全拔除的替代技术。
背景:下颌第三磨牙(MTM)的拔除是口腔外科中最常见的手术之一。这种干预并非没有风险,因为最常见的一种是下肺泡神经(IAN)的损伤。本系统综述的主要目的是比较冠状切除术技术与传统的MTM提取技术对IAN的高损伤风险,从而确定冠状切除术是否是预防神经损伤的有效手术选择。材料与方法:于2024年10月在pubm - med和Cochrane-Database数据库中进行文献检索,获得211篇研究。最后,系统评价纳入16项研究,共纳入2551例患者。冠状切除2280例,拔牙841例。结果:6.22%的冠状动脉切除术不成功。拔牙组IAN损伤发生率为6.53%,冠状切除组仅为0.56%。永久性IAN损伤分别为1.18%和0.13%。两组最常见的并发症是术后疼痛,结果相似,拔牙组为15.69%,冠状切除术组为14.21%。两组舌神经损伤均不常见且短暂,影响0.12%的拔牙和0.26%的冠状切除。冠状切除术组发生率最高的并发症是牙根移位,主要发生在前6个月。结论:冠状动脉切除术是一种安全有效的治疗MTM的替代技术。
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来源期刊
Medicina Oral Patologia Oral Y Cirugia Bucal
Medicina Oral Patologia Oral Y Cirugia Bucal DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
4.60
自引率
0.00%
发文量
52
审稿时长
3-8 weeks
期刊介绍: 1. Oral Medicine and Pathology: Clinicopathological as well as medical or surgical management aspects of diseases affecting oral mucosa, salivary glands, maxillary bones, as well as orofacial neurological disorders, and systemic conditions with an impact on the oral cavity. 2. Oral Surgery: Surgical management aspects of diseases affecting oral mucosa, salivary glands, maxillary bones, teeth, implants, oral surgical procedures. Surgical management of diseases affecting head and neck areas. 3. Medically compromised patients in Dentistry: Articles discussing medical problems in Odontology will also be included, with a special focus on the clinico-odontological management of medically compromised patients, and considerations regarding high-risk or disabled patients. 4. Implantology 5. Periodontology
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