Le Lam Nguyen, Truong Khue Nhut, Kim Vinh Ngoc Khanh, Lam Tan Nhat, Le Khanh Vu Phuong
Department of Pediatrics Dentistry and Orthodontics, Faculty Odonto-Stomatology, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
Department of Oral and Maxillofacial Surgery, Faculty Odonto-Stomatology, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
J Maxillofac Oral Surg. 2024 Dec;23(6):1462-1469. doi: 10.1007/s12663-024-02303-4. Epub 2024 Aug 12.
To evaluate the efficacy of treatment following coronectomy on mandibular third molars with inferior alveolar nerve (IAN) involvement.
A cross-sectional descriptive analysis was done on the mandibular third molars of 37 people (≥ 18 years old, 28 males, and 9 females) who needed a coronectomy and had a confirmed diagnosis of IAN in groups I, II, and III according to the classification of Q. Luo 2018, as found by CBCT.
The most prevalent indication in panoramic photographs was an interruption of the canal sign's white line (45.9%). The coronectomy approach had a success rate of 100%. There were statistically significant differences in the degree of vertical and horizontal face swelling, as well as mouth opening, between the second and third postoperative days. No incidences of paresthesia were reported after surgery. The root migrated the most in the first 3 months following surgery, measuring 2.43 ± 1.08 mm. At 6 months following surgery, the root migrated by 2.95 ± 1.27 mm. At 9 months following surgery, the root migrated 3.04 ± 1.19 mm from its initial location.
The risk of complications after a coronectomy seems to be inadequate, at least in the immediate aftermath of the operations. Coronectomy may be required for molars that are close to the IAN. Due to the roots often receding from the IAN, a second procedure to remove the remaining roots is typically performed with minimal risk of paresthesia.
评估下颌第三磨牙行冠切除术且伴有下牙槽神经（IAN）受累时的治疗效果。
对37例（年龄≥18岁，男28例，女9例）需要进行冠切除术且经CBCT检查确诊为IANⅠ、Ⅱ、Ⅲ类（根据Q. Luo 2018分类）的下颌第三磨牙进行横断面描述性分析。
全景片上最常见的表现是根管白线中断（45.9%）。冠切除术的成功率为100%。术后第二天和第三天在垂直和水平面部肿胀程度以及开口度方面存在统计学显著差异。术后未报告感觉异常事件。术后前3个月牙根迁移最多，为2.43±1.08毫米。术后6个月，牙根迁移了2.95±1.27毫米。术后9个月，牙根从初始位置迁移了3.04±1.19毫米。
至少在手术后即刻，冠切除术后并发症的风险似乎较低。靠近IAN的磨牙可能需要进行冠切除术。由于牙根通常会从IAN退缩，因此通常进行第二次手术以去除剩余牙根，且感觉异常风险极小。
