Coronectomy

What is coronectomy?

A coronectomy is a procedure that involves removing the crown of a lower wisdom tooth while keeping the roots behind in the bone. When a lower wisdom tooth becomes impacted (growing either sideways, horizontally, diagonally, forwards or backwards) problems can occur for the gum and surrounding teeth.

Often, removal of the wisdom tooth is the best option to protect the region from infection and damage. However, lower wisdom teeth can lie extremely close to the inferior alveolar nerve. This nerve supplies the lower lip with sensory sensation. There is a risk of damaging this nerve when extracting a lower wisdom tooth.

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alveolar nerve pain

What is the alveolar nerve?

The alveolar nerve stems from the mandibular nerve that runs through the lower jaw. This nerve is responsible for the sensory sensations felt in the lower jaw and lower lip. Therefore, if any damage was to occur to that nerve, a patient could be left in pain or may be left partially or completely numb in that region. Sensory sensation could also be altered in the lower lip, chin, and skin either temporarily or permanently.

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Coronectomy

Advantages of a coronectomy

  • It can prevent nerve damage and altered sensation to the lower jaw, gum and lower lip.
  • Coronectomy is a less invasive procedure than a full wisdom tooth extraction.

Potential disadvantages of a coronectomy

  • There is a small chance that a coronectomy could fail. However, when compared to the risk of nerve damage with a full extraction, often a coronectomy is the safer option.
  • A coronectomy is not always appropriate and it can only be considered if the tooth is healthy and free from advanced tooth decay and chronic infection.
  • The tooth roots may in time erupt through the gum, at which point it can be extracted without damaging the nerve.

How we decide whether to perform a coronectomy or not

Using normal x-rays sometimes it is not possible to know exactly how close the wisdom tooth is to the inferior alveolar nerve. By taking a CBCT 3D X-ray, we can let you know if your wisdom tooth is lying very close to the inferior alveolar nerve and inform you if it is too risky to do a full wisdom tooth extraction. If the wisdom tooth is very close to the nerve, then a coronectomy could be the best choice and we are pleased to offer this treatment option to our patients.

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