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References

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To retrieve or not to retrieve the coronectomy root – the clinical dilemma

From Volume 40, Issue 5, June 2013 | Pages 370-376

Authors

Vinod Patel

BDS (Hons), PhD

Consultant (Oral Surgery), Oral Surgery Department, Guy's and St Thomas' NHS Foundation Trust, London

Articles by Vinod Patel

Email Vinod Patel

Jerry Kwok

Consultant (Oral Surgery), Oral Surgery Department, Floor 23, Guy's Dental Hospital, London Bridge, London, SE1 9RT, UK

Articles by Jerry Kwok

Chris Sproat

BDS(Lond), MBBS(Hons), BSc(Hons), FDS RCS

Consultant (Oral Surgery), Oral Surgery Department, Floor 23, Guy's Dental Hospital, London Bridge, London, SE1 9RT, UK

Articles by Chris Sproat

Mark McGurk

MD, FRCS, DLO, FDS, RCS

Consultant, Department of Oral and Maxillofacial Surgery, Guy's, King's and St Thomas' Dental Institute, SE1 9RT, UK

Articles by Mark McGurk

Abstract

Abstract: Coronectomy of mandibular third molars is a well established technique that is going through a resurgence as it seems to reduce the risk of inferior dental nerve (IDN) injury. The reservation with the technique arises because of fear that the retained root will become infected and symptomatic over time. General dental practitioners will be responsible for the long-term review and care of these patients and, consequently, it is important that they are aware of the technique and its sequelae.

Clinical Relevance: Coronectomy of mandibular third molars to avoid nerve injury is becoming increasingly popular. It is important that general dental practitioners (GDPs) are aware of the immediate and later sequelae of treatment and the implication of the retained root.

Article

Coronectomy is now being proposed as a treatment option for mandibular third molars deemed on radiographic assessment to be at risk of inferior dental nerve injury. However, there is understandable concern amongst clinicians, who are sceptical of the value of the technique, as a root is retained in the socket and with it lies the prospect of late complications, such as infection. Furthermore, the fact that a retained root remains in the socket may cause a diagnostic issue if the surgical site remains symptomatic and may lead to other causes being overlooked. In the presence of rather non-specific symptoms, the dilemma is whether they arise from the retained root or were just a consequence of the surgical procedure. In the former instance, the root should be retrieved but may still carry the risk of injury to the IDN. Post coronectomy patients are likely to be encountered more frequently by GDPs as the technique becomes more popular. It is therefore prudent that GDPs have some knowledge of the common causes of symptoms post-coronectomy and their optimum management. In this paper, the authors share their expertise based on experience gained from coronectomy procedures undertaken at Guy's Oral Surgery Department.

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