Council of Dental specialties, Kurdistan Higher Council of Medical Specialties, Erbil, Iraq.
Int Dent J. 2024 Apr;74(2):195-198. doi: 10.1016/j.identj.2023.07.015. Epub 2023 Aug 8.
The aim of this research was to evaluate the surgical complications and neurosensory deficits after coronectomy and the complete removal of mandibular third molars.
The study sample included patients requiring surgical removal of mandibular third molars. A coronectomy was conducted on 220 teeth showing signs of close proximity to the inferior alveolar canal. A complete extraction was performed on 218 teeth with no risk signs. The patients were evaluated at 1 week and 1, 3, 6, 12, and 24 months after surgery for pain, swelling, neurologic deficit, dry socket, postoperative bleeding, infection, root migration, and eruption.
No significant difference was noted in pain and swelling; however, bleeding and dry socket were significantly higher in the odontectomy group (P = .017). The inferior alveolar nerve deficit was higher in the odontectomy group (3.7%) than the coronectomy group (0.5%) (P = .017). The percentage and distance of root migration of coronectomised teeth at 3, 6, and 12 months were 60% (2.37 ± 0.96 mm), 66% (3.35 ± 0.86 mm), and 74% (3.85 ± 0.93 mm), respectively.
Coronectomy is a safe procedure and should be performed when the roots are closely associated with the mandibular canal. Although root migration is common, the likelihood of root exposure is low and roots rarely need removal.
本研究旨在评估冠根切除术和下颌第三磨牙完全拔除术后的手术并发症和神经感觉缺失情况。
研究样本包括需要手术拔除下颌第三磨牙的患者。对 220 颗有接近下牙槽神经管迹象的牙齿进行冠根切除术。对 218 颗无风险迹象的牙齿进行完全拔除术。术后 1 周、1、3、6、12 和 24 个月，对患者进行疼痛、肿胀、神经功能缺损、干槽症、术后出血、感染、根迁移和萌出情况评估。
疼痛和肿胀无显著差异；然而，拔牙组的出血和干槽症发生率显著高于冠根切除术组（P =.017）。拔牙组的下牙槽神经缺损发生率（3.7%）高于冠根切除术组（0.5%）（P =.017）。3、6 和 12 个月时冠根切除术组牙齿的根迁移百分比和距离分别为 60%（2.37 ± 0.96 mm）、66%（3.35 ± 0.86 mm）和 74%（3.85 ± 0.93 mm）。
冠根切除术是一种安全的手术方法，当牙根与下颌管密切相关时应进行该手术。尽管根迁移很常见，但根暴露的可能性较低，且很少需要去除牙根。
