Evaluation of the Outcomes of Coronectomy Procedure versus Surgical Extraction of Lower Third Molars Which Have a High Risk for Inferior Alveolar Nerve Injury: A Systematic Review

Background and Objectives. Surgical extraction of mandibular third molars (3rd M) may cause inferior alveolar nerve injury (IANI), whereas in coronectomy the crowns of 3rd M are removed, keeping the roots intact to avoid IANI. This study aims to review the literature which evaluated coronectomy effe...

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Main Authors: Nedal Abu-Mostafa, Lulwah M. AlRejaie, Fahad A. Almutairi, Ruba A. Alajaji, Maram M. Alkodair, Nourah A. Alzahem
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:International Journal of Dentistry
Online Access:http://dx.doi.org/10.1155/2021/9161606
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author Nedal Abu-Mostafa
Lulwah M. AlRejaie
Fahad A. Almutairi
Ruba A. Alajaji
Maram M. Alkodair
Nourah A. Alzahem
author_facet Nedal Abu-Mostafa
Lulwah M. AlRejaie
Fahad A. Almutairi
Ruba A. Alajaji
Maram M. Alkodair
Nourah A. Alzahem
author_sort Nedal Abu-Mostafa
collection DOAJ
description Background and Objectives. Surgical extraction of mandibular third molars (3rd M) may cause inferior alveolar nerve injury (IANI), whereas in coronectomy the crowns of 3rd M are removed, keeping the roots intact to avoid IANI. This study aims to review the literature which evaluated coronectomy effectiveness as an alternative for surgical extraction of 3rd M that have a high risk of trauma to the inferior alveolar canal. A computerized literature search was conducted on the databases PubMed, SCOPUS, and ScienceDirect to gather information regarding the coronectomy procedure from inception till June 5, 2020. A total of 97 articles were identified, and seven studies were finally included for conducting qualitative analysis: 3 randomized clinical trials and 4 clinical controlled trials. Cochrane Collaboration’s tool was used for assessing risk of bias. Coronectomy procedures were performed on 15–171 teeth. In the control group, extraction procedures were done on 15–178 teeth. Results. No study reported permanent inferior alveolar nerve injury (p-IANI) regarding coronectomy; however, transient inferior alveolar nerve injury (t-IANI) was reported in 0–2.20% of successful coronectomy and 0–8% of failed coronectomy. Postextraction t-IANI ranged from 0% to 16.66% while p-IANI from 0% to 3.63%. In 5 studies, root migration occurred in 2% to 85.3% of cases and the distance rate was 2.33–3.43 mm at 6 months postoperatively; then the migration gradually decreased and stopped at 12 months. Conclusion. This systematic review revealed that coronectomy is an efficient alternative for the management of impacted 3rd M with a high risk of IANI. Patients who got antibiotics postcoronectomy procedures had lower infection rates than those who did not receive antibiotic therapy. We recommend further research on coronectomy with longer follow-up periods to assess the retained roots’ long-term outcomes and to assess the effect of antibiotics administration on postcoronectomy infection rate. This systematic review is registered under number CRD42020198394.
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spelling doaj-art-8156bc43cfc44c2f8e958bfdec9b37482025-02-03T06:44:02ZengWileyInternational Journal of Dentistry1687-87362021-01-01202110.1155/2021/9161606Evaluation of the Outcomes of Coronectomy Procedure versus Surgical Extraction of Lower Third Molars Which Have a High Risk for Inferior Alveolar Nerve Injury: A Systematic ReviewNedal Abu-Mostafa0Lulwah M. AlRejaie1Fahad A. Almutairi2Ruba A. Alajaji3Maram M. Alkodair4Nourah A. Alzahem5Oral and Maxillofacial Surgery and Diagnostic Science DepartmentRiyadh Elm UniversityMajmaah UniversityKing Saud UniversityKing Khalid UniversityKing Khalid UniversityBackground and Objectives. Surgical extraction of mandibular third molars (3rd M) may cause inferior alveolar nerve injury (IANI), whereas in coronectomy the crowns of 3rd M are removed, keeping the roots intact to avoid IANI. This study aims to review the literature which evaluated coronectomy effectiveness as an alternative for surgical extraction of 3rd M that have a high risk of trauma to the inferior alveolar canal. A computerized literature search was conducted on the databases PubMed, SCOPUS, and ScienceDirect to gather information regarding the coronectomy procedure from inception till June 5, 2020. A total of 97 articles were identified, and seven studies were finally included for conducting qualitative analysis: 3 randomized clinical trials and 4 clinical controlled trials. Cochrane Collaboration’s tool was used for assessing risk of bias. Coronectomy procedures were performed on 15–171 teeth. In the control group, extraction procedures were done on 15–178 teeth. Results. No study reported permanent inferior alveolar nerve injury (p-IANI) regarding coronectomy; however, transient inferior alveolar nerve injury (t-IANI) was reported in 0–2.20% of successful coronectomy and 0–8% of failed coronectomy. Postextraction t-IANI ranged from 0% to 16.66% while p-IANI from 0% to 3.63%. In 5 studies, root migration occurred in 2% to 85.3% of cases and the distance rate was 2.33–3.43 mm at 6 months postoperatively; then the migration gradually decreased and stopped at 12 months. Conclusion. This systematic review revealed that coronectomy is an efficient alternative for the management of impacted 3rd M with a high risk of IANI. Patients who got antibiotics postcoronectomy procedures had lower infection rates than those who did not receive antibiotic therapy. We recommend further research on coronectomy with longer follow-up periods to assess the retained roots’ long-term outcomes and to assess the effect of antibiotics administration on postcoronectomy infection rate. This systematic review is registered under number CRD42020198394.http://dx.doi.org/10.1155/2021/9161606
spellingShingle Nedal Abu-Mostafa
Lulwah M. AlRejaie
Fahad A. Almutairi
Ruba A. Alajaji
Maram M. Alkodair
Nourah A. Alzahem
Evaluation of the Outcomes of Coronectomy Procedure versus Surgical Extraction of Lower Third Molars Which Have a High Risk for Inferior Alveolar Nerve Injury: A Systematic Review
International Journal of Dentistry
title Evaluation of the Outcomes of Coronectomy Procedure versus Surgical Extraction of Lower Third Molars Which Have a High Risk for Inferior Alveolar Nerve Injury: A Systematic Review
title_full Evaluation of the Outcomes of Coronectomy Procedure versus Surgical Extraction of Lower Third Molars Which Have a High Risk for Inferior Alveolar Nerve Injury: A Systematic Review
title_fullStr Evaluation of the Outcomes of Coronectomy Procedure versus Surgical Extraction of Lower Third Molars Which Have a High Risk for Inferior Alveolar Nerve Injury: A Systematic Review
title_full_unstemmed Evaluation of the Outcomes of Coronectomy Procedure versus Surgical Extraction of Lower Third Molars Which Have a High Risk for Inferior Alveolar Nerve Injury: A Systematic Review
title_short Evaluation of the Outcomes of Coronectomy Procedure versus Surgical Extraction of Lower Third Molars Which Have a High Risk for Inferior Alveolar Nerve Injury: A Systematic Review
title_sort evaluation of the outcomes of coronectomy procedure versus surgical extraction of lower third molars which have a high risk for inferior alveolar nerve injury a systematic review
url http://dx.doi.org/10.1155/2021/9161606
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