Coronectomy: A Surgical Option for Impacted Third Molars in Close Proximity to the Inferior Alveolar Nerve—A 5-Year Follow-Up Study

Monaco, Giuseppe; D'Ambrosio, Mattia; Santis, G. De; Vignudelli, Elisabetta; Gatto, Maria Rosaria; Corinaldesi, Giuseppe

doi:10.1016/j.joms.2018.12.017

Cited by 30 publications

(56 citation statements)

References 28 publications

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“…Still, in order to minimize neurosensory complications, early removal of the third molars may be advised if it is observed that the third molar roots are reaching out towards the mandibular canal without proper chances of functional eruption. According to this, and in line with the study of Monaco et al, we found that impacted fully developed third molars are at increased risk of being in a relationship with the mandibular canal, compared to erupted third molars. In these cases, early removal may have been advised, or other surgical procedures such as coronectomy are to be advocated …”

Section: Discussionsupporting

confidence: 91%

“…In these cases, early removal may have been advised, or other surgical procedures such as coronectomy are to be advocated. [25][26][27] Major limitation of the present study is the lack of retromolar eruption space measurements, which is considered at least as important as the angulation of the third molar itself. The dimensions of the dental arch are largely predefined by ones genetics.…”

Section: Discussionmentioning

confidence: 95%

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Radiographic prediction of mandibular third molar eruption and mandibular canal involvement based on angulation

Vranckx

Ockerman

Coucke

et al. 2019

Orthod Craniofacial Res

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Structured Abstract Objectives The aim of our study was to identify and predict patients at risk of impeded mandibular third molar eruption and potential relation between the third molar roots and the mandibular canal, based on molar angulations in an early development stage. Setting and Sample Population A total of 1011 adolescent orthodontic patients were included in this longitudinal study. Materials and Methods We analysed pre‐eruptive rotational changes and root development of mandibular third molars on 2022 panoramic radiographs (two time‐points). Five variables were evaluated: third molar eruption level, development stage, risk of relation between the third molar and the mandibular canal, the molar angulations and orthodontic treatment. The relation between early third molar angulation and mean annual angulation change was assessed using a linear mixed model. Logistic regression was applied to investigate a potential correlation of the radiographic variables with the eruption potential and risk of developing a relation between the third molar and the mandibular canal. Results Mandibular third molar follicles with an initial angulation exceeding 27.0° relative to the second molar tend to progressively increase their angulation during further development. A significant correlation was found between the hemimandibular molar angulations and the probability of eruption (P < 0.0001). The second to first molar angulation was predictive for potential development of a relation with the mandibular canal (P = 0.005). Conclusion From the present data, it appears that severely angulated mandibular third molars (>27.0°) have a minimal chance of future eruption and a maximal risk of developing a relation with the mandibular canal.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 95%

Radiographic prediction of mandibular third molar eruption and mandibular canal involvement based on angulation

Vranckx

Ockerman

Coucke

et al. 2019

Orthod Craniofacial Res

View full text Add to dashboard Cite

show abstract

“…A bony impacted root complex regenerated more bone distal to the M2M than that observed for soft tissue-impacted roots (r = 0.27, P ≤ 0.001), data that are in accordance with results from a study by Yeung [23]. A correlation was not found between reduction in DBD depth and root migration, as reported previously [14,31]. Analyses of the coronectomy-related factors mentioned above suggested that the remaining root complex did not disturb periodontal healing of the M2M.…”

Section: Discussionsupporting

confidence: 90%

“…Rotation of the root complex can be observed in 65% of patients after coronectomy [28]. The positive relationship between root rotation and reduction in DBD depth has been considered to be orthodontic traction [31]. A bony impacted root complex regenerated more bone distal to the M2M than that observed for soft tissue-impacted roots (r = 0.27, P ≤ 0.001), data that are in accordance with results from a study by Yeung [23].…”

Section: Discussionsupporting

confidence: 83%

“…Analyses of the coronectomy-related factors mentioned above suggested that the remaining root complex did not disturb periodontal healing of the M2M. Re-contact of the root complex and distal surface of the M2M was a potential risk factor for the periodontal condition of the M2M; it caused two in ve patients to undergo secondary surgery after coronectomy in a study by Monaco [32]. Meanwhile, a M3M with a complete root apex can erupt upon application of mechanical force to a M2M [33] and increase the risk of external root resorption [34].…”

Section: Discussionmentioning

confidence: 99%

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Computer-aided three-dimensional assessment of periodontal healing distal to the mandibular second molar after coronectomy of the mandibular third molar: a prospective study

Yan

Tan

Xie

et al. 2020

Preprint

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Background The periodontal healing distal to the mandibular second molar (M2M) after coronectomy of the M3M was controversary. This study aimed to combine a digital method with cone-beam computed tomography (CBCT) and estimate periodontal healing of M2M after M3M coronectomy. An accurate and stable indicator in three dimensions was also tentatively explored. Methods Patients with a M3M in contact with the inferior alveolar canal were included. CBCT was applied immediately after coronectomy (baseline) and 6-months later. Data were investigated with digital software for registration. Previously reported and coronectomy-related factors were included for univariate and multivariate analyses. Results A total of 181 patients (213 M3Ms) completed 6-month follow-up. Significant reduction in the distal intra-bony defect (DBD) depth of the M2M was shown (1.28 ± 1.24 mm, P < 0.001). DBD depth of the M2M at baseline was the most influential factor (r = 0.59), followed by preoperative M3M condition, age, rotation and eruption of the root complex. Remaining enamel (OR = 6.93) and small retromolar space (0.67) contributed to re-contact of the root complex and M2M. Bone volume regenerated in the distal 2 mm was associated significantly with DBD-depth reduction (r = 0.74, P < 0.001). Conclusions Bone volume regenerated in the distal 2 mm of the M2M denoted stability of distal periodontal healing of the M2M. DBD depth at baseline was the most influential factor for healing of a DBD of the M2M after M3M coronectomy. The remaining enamel and a small retromolar space could contribute to re-contact of the root complex and the M2M. Trial registration: China Clinical Trial Center, ChiCTR1800014862. Registered 10 February 2018, http://www.chictr.org.cn/showproj.aspx?proj=24216

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Comprehensive review of lower third molar management: A guide for improved informed consent

et al. 2020

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Lower third molar removal is the most commonly performed dental surgical procedure. Nevertheless, it is difficult to ensure that all the informed consent forms given to patients are based on the best evidence as many newer publications could change the conclusions of previous research. Therefore, the goal of this review article is to cover existing meta‐analyses, randomized control trials, and related articles in order to collect data for improved and more current informed consent.

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Coronectomy: A Surgical Option for Impacted Third Molars in Close Proximity to the Inferior Alveolar Nerve—A 5-Year Follow-Up Study

Cited by 30 publications

References 28 publications

Radiographic prediction of mandibular third molar eruption and mandibular canal involvement based on angulation

Radiographic prediction of mandibular third molar eruption and mandibular canal involvement based on angulation

Computer-aided three-dimensional assessment of periodontal healing distal to the mandibular second molar after coronectomy of the mandibular third molar: a prospective study

Comprehensive review of lower third molar management: A guide for improved informed consent

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