CORONECTOMY - A SAFE APPROACH TO WISDOM TOOTH REMOVAL WHEN THE ROOT IS CLOSE TO THE INFERIOR ALVEOLAR NERVE

💡 Not all wisdom tooth extractions are the same. In certain cases, wisdom teeth erupt in complex positions, and conventional extraction methods may pose a risk of nerve injury, potentially leading to prolonged numbness of the lips or chin. 

✅ That is why, when the roots of a wisdom tooth are located extremely close to the inferior alveolar nerve, dentists may not recommend immediate full extraction. Instead, a more sustainable treatment option may be considered: Coronectomy – a controlled wisdom tooth extraction that intentionally preserves the roots. 

Join Specialist Level 1 Doctor Bui Xuan Dat - Dental Specialty at CarePlus, to learn more about this specialized wisdom tooth extraction technique in the article below. 

1️⃣ Coronectomy – A Controlled Wisdom Tooth Extraction Technique That Preserves the Roots 

❗ In oral surgery, removal of the mandibular third molar (MTM) is a common procedure. A significant associated risk is temporary or permanent sensory alteration of the lower lip, chin skin, teeth, and gingiva on the operated side due to iatrogenic injury to the inferior alveolar nerve (IAN). 

✅ Coronectomy is a technique in which only the crown of the tooth is removed while the roots, often located in close proximity to the inferior alveolar nerve, are intentionally left in place to minimize the risk of nerve injury. 

🔎 The retained roots are monitored periodically. Over time, they are gradually covered by bone and, if stable, do not interfere with chewing function. 

✅ According to the American Association of Oral and Maxillofacial Surgeons (AAOMS): 

When mandibular third molars present a high risk of inferior alveolar nerve injury and require removal, coronectomy may reduce the risk of inferior alveolar nerve injury (IANI) and lingual nerve injury (LNI), as well as lower the incidence of dry socket compared with conventional extraction. 

The decision to perform a coronectomy is based on a thorough evaluation by an Oral and Maxillofacial specialist, considering clinical findings, panoramic X-rays, or Cone Beam CT imaging to assess the relationship between the tooth roots and the nerve, along with the patient’s preferences and informed consent. 

2️⃣️️ The Coronectomy Procedure at CarePlus 

🔷 The dentist identifies cases indicated for coronectomy, including: 

🔹 Tooth roots located extremely close to or intersecting with the inferior alveolar nerve (IAN). 

🔹 Roots positioned adjacent to the lingual cortical plate, where complete root removal may risk fracture of the bone plate and potential injury to the lingual nerve (LN). 

🔷 The dentist schedules a consultation to explain possible complications associated with complete root extraction. Once the patient agrees to the coronectomy approach, the procedure is performed. The surgical process follows standard protocols: the crown is sectioned and removed, the area is thoroughly cleaned, sharp edges are smoothed, and the site is sutured. 

🔷 The healing process is similar to that of conventional extraction. Postoperative discomfort typically subsides within 2–3 days. Importantly, patients do not experience numbness of the lips, tongue, or one side of the face, risks that may occur when attempting complete root removal. The retained roots are gradually encased in bone after healing and coexist harmoniously with surrounding tissues. 

🔷 Customers are advised to return every 6 months for scaling and follow-up examinations to assess the retained roots within the alveolar bone. 

3️⃣ Why Choose CarePlus for Complex Wisdom Tooth Extraction? 

✅ Highly experienced dentists with international training 

✅ Modern facilities and advanced equipment 

✅ Gentle techniques that minimize swelling and pain, ideal for busy patients 

✅ Thorough postoperative follow-up and care 

The more complex the wisdom tooth case, the more important it is to choose the right clinic and a highly qualified dentist you can trust. 

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