van Bodegraven Arjan, Simons Rashida N, Tuk Jacco G, de Lange Jan, Lindeboom Jerome A H
Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Private Practice, Amstelland Hospital, Amstelveen, The Netherlands.
Oral Maxillofac Surg. 2025 Jan 24;29(1):44. doi: 10.1007/s10006-025-01340-8.
Coronectomy is a valuable treatment proven safe for non-pathological mandibular third molars with an increased risk of inferior alveolar nerve injury. Coronectomy may also be useful for mandibular third molars with dentigerous cysts and caries, but this is not commonly performed due to the lack of well-designed, evidence-based studies. Here, we aim to investigate the safety of coronectomy for mandibular third molars with caries and dentigerous cysts.
One hundred fifteen patients with an impacted mandibular third molar with a dentigerous cyst or caries underwent coronectomy or complete removal and received follow-up with clinical and radiographical examinations. We statistically compared the presence of postoperative complications after coronectomy versus complete removal.
Data from 121 molars were available for analysis. The results revealed no significant difference in the occurrence of postoperative complications (including persistent pain, inferior alveolar nerve injury, infection, alveolar osteitis, excessive bleeding, and the need for retreatment) between coronectomy and complete removal. Additionally, the incidence of postoperative complications was not related to any analyzed patient- or molar-related factors, including age, gender, health status, smoking, caries, dentigerous cyst extent, and impaction degree.
For pathological impacted mandibular third molars with dentigerous cysts and caries, coronectomy exhibited both short-term and long-term safety, showing no significant difference in postoperative complications compared to total removal. Our results suggest that coronectomy can be indicated for pathological mandibular third molars with proximity to the inferior alveolar nerve.
Not applicable.
牙冠切除术是一种经证实对下牙槽神经损伤风险增加的非病理性下颌第三磨牙安全有效的治疗方法。牙冠切除术对于伴有含牙囊肿和龋齿的下颌第三磨牙也可能有用，但由于缺乏精心设计的、基于证据的研究，这种手术并不常用。在此，我们旨在研究牙冠切除术治疗伴有龋齿和含牙囊肿的下颌第三磨牙的安全性。
115例患有含牙囊肿或龋齿的下颌阻生第三磨牙患者接受了牙冠切除术或完整拔除术，并接受了临床和影像学检查随访。我们对牙冠切除术后与完整拔除术后的术后并发症情况进行了统计学比较。
121颗磨牙的数据可用于分析。结果显示，牙冠切除术和完整拔除术在术后并发症（包括持续性疼痛、下牙槽神经损伤、感染、干槽症、出血过多以及再次治疗的必要性）的发生率上没有显著差异。此外，术后并发症的发生率与任何分析过的患者或磨牙相关因素均无关，包括年龄、性别健康状况、吸烟、龋齿、含牙囊肿范围和阻生程度。
对于伴有含牙囊肿和龋齿的病理性下颌阻生第三磨牙，牙冠切除术在短期和长期均显示出安全性，与完全拔除相比，术后并发症无显著差异。我们的结果表明，对于靠近下牙槽神经的病理性下颌第三磨牙，可以考虑采用牙冠切除术。
不适用。
