Coronectomy: A Solution to Wisdom Tooth Problems
What is a Coronectomy?
A coronectomy is a dental procedure that removes the coronal portion of a wisdom tooth, intentionally leaving part of the root(s) in place. Wisdom teeth (also known as third molars) may be located near nerves and other vital structures. Removing the entire tooth may sometimes put those structures at risk of damage.
Careful removal of the coronal portion of the tooth may reduce the risk of complications in some individuals. Your oral and maxillofacial surgeon (OMS) can clarify when a coronectomy may be recommended.
When is a Coronectomy Recommended?
A coronectomy can be a good choice in certain circumstances. Advantages include:
- Nerve protection: Mandibular wisdom tooth roots are often located near important nerves in the jaw. This sensory nerve provides feeling to the lower part of the jaw, teeth, gums, lower lip and skin of the chin. In some cases, removing the entire tooth can damage these nerves, resulting in numbness and other complications. A coronectomy intentionally leaves a portion of the roots of the tooth in place, reducing the risk of nerve damage.
- Risk mitigation: Some wisdom teeth are deeply impacted or surrounded by dense bone. Gaining access to the entire tooth might require excessive bone removal or damage a neighboring tooth. A coronectomy can eliminate the need for a complete extraction, minimizing potential damage to adjacent structures and preserving bone structure. This helps reduce postoperative complications.
When is a Coronectomy Not Recommended
A coronectomy will not be utilized if your wisdom teeth or roots are decaying or infected. Despite planning for a coronectomy, should the roots become mobile or loose during the procedure, they may require removal.
What to expect with a Coronectomy
Here are the steps an OMS may take when considering a coronectomy:
- Evaluation: Your OMS will carefully examine the wisdom teeth using X-rays or other imaging techniques to assess their location and proximity to the nerve and neighboring structures. Based on the evaluation, your OMS can decide if a coronectomy is an option for you.
- Preparation for the procedure: Before your coronectomy, your OMS will explain the procedure and answer your questions. Your OMS also will discuss anesthesia options, so you are comfortable throughout the procedure.
- Surgery: Your OMS will access the impacted tooth, likely entering through the gums and removing some of the bone around the tooth. Your OMS will carefully section the coronal portion of the tooth and intentionally leave a portion of the root in place. The surgical site will be thoroughly cleaned and sutured to complete the procedure.
- Recovery: After your coronectomy, your OMS will provide detailed postoperative instructions. Swelling and discomfort are normal, but over-the-counter pain relievers and cold compresses can help alleviate these symptoms. Follow-up appointments may be made to monitor healing and ensure there are no complications. If an infection develops, the OMS will need to remove the remaining root and clean the area thoroughly.
- Continued monitoring: Your OMS and general dentist can monitor the roots to see if they move over time or start to erupt. Your OMS may recommend a procedure to remove them at a later stage. If this occurs, the roots have usually moved away from the nerve or neighboring teeth.
If you have a problem with your wisdom teeth, talk to an OMS to determine if a coronectomy is the right option for you.
