Coronectomy versus Extraction of Third Molar with Inferior Alveolar Nerve Proximity: A Cross-sectional Study

Abstract

Introduction: A tooth that failed to erupt in its expected time of eruption is called impacted tooth. Mandibular impacted teeth are common than any other tooth. Management of impacted teeth depends upon depth, angulations and type of impaction. Certain factors may increase the complications of tooth extraction. One of them is Inferior Alveolar Nerve (IAN) approximation with third molar roots. Coronectomy is surgical procedure through which crown of tooth can be removed at cementoenamel junction level and leaving the root part is a new procedure to avoid nerve injury. Aim: To compare outcome of extraction of lower third molar and coronectomy in management of impacted third molar with close proximity to inferior alveolar nerve. Materials and Methods: This cross-sectional study was conducted at Oral and Maxillofacial Surgery Department at Liaquat University of Medical and Health Science Jamshoro/ Hyderabad, Pakistan. Ethical approval was sought from the ethical review committee of university. The written informed consent was taken from the patients. Total 36 patients were included in this study, divided into two groups using random number table. Patients with mandibular impacted third molar, with inferior alveolar nerve approximation diagnosed clinically and radiographically were included in this study. Group A was treated with surgical extraction and group B with Coronectomy. The data was analysed by Statistical Package for the Social Sciences (SPSS) statistical software version 20.0. The Chi-square test and Independent t-test was applied to check the statistical difference in outcomes of both treatment procedures. Results: Total 36 patients were included in two groups and the mean age of patients were 25±2 years with male to female ratio as 1.1:1. Preoperatively, all patients were having normal mouth opening and no neurosensory deficit. Postoperatively neurosensory deficit seen in both groups at follow-up visits but, at six weeks follow-up, all patients were recovered from IAN deficit in coronectomy group with statistically significant p-value <0.001. Conclusion: With this small sample size, it cannot be concluded which technique is better than other. With this single centre study, it was observed that coronectomy appears to be simple, easier and better procedure and more effective technique for minimising the risk to inferior alveolar nerve injury, limited mouth opening and dry socket that corresponds to impacted molar extraction.

Keywords

• inferior alveolar nerve injury
• orthopantomogram
• two point discrimination