Sharif Umar, Lie Stein Atle, Gjerde Cecilie Gudveig
Faculty of Medicine, Center of Translational Oral Research (TOR), Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
Faculty of Medicine, Center of Translational Oral Research (TOR), Department of Clinical Dentistry, University of Bergen, 5009, Bergen, Norway.
Acta Odontol Scand. 2025 May 26;84:284-291. doi: 10.2340/aos.v84.43759.
Mandibular third molars (3M) are often associated with pathologies necessitating their surgical removal. Removal of 3M can cause injury to the inferior alveolar nerve (IAN). In coronectomy, a surgical option for 3M that present a significant risk of injury to the IAN, only the crown is removed, and the root/roots are left in situ, and may move after surgery. Methodology: A retrospective review was done to analyse the outcomes of coronectomy procedures performed at the Clinic of Oral and Maxillofacial Surgery, Institute of Clinical Odontology (IKO), University of Bergen (UiB) between 2014 and 2020. During this period, a total of 63 coronectomy procedures were performed. All 63 patients were contacted after approval from the regional ethical committee, and a total of 44 patients consented to participate in the study. Radiographic analysis was done based on panoramic radiographs (OPG), and patient records were analysed to assess which demographic and local factors were associated with root migration along with the number of post-operative complications. Results: Root migration was not associated with gender, root anatomy, or pattern of tooth impaction. Root migration was observed significantly more often in the younger age group, that is, ≤25 years. There were four reported cases of post-operative complications; two of those cases resolved with systemic antibiotics, while surgical intervention was necessary in the other two cases to remove the remaining roots. There were no reported cases of transient or permanent neurosensory disturbances. Conclusion: Coronectomy is a viable technique to avoid nerve injury with 3M removal.
下颌第三磨牙（3M）常伴有需要手术拔除的病变。拔除3M可能会损伤下牙槽神经（IAN）。在冠切术（一种针对有IAN损伤重大风险的3M的手术选择）中，仅切除牙冠，牙根留在原位，术后可能会移动。方法：进行回顾性分析，以评估2014年至2020年期间在卑尔根大学临床牙科学研究所（IKO）口腔颌面外科诊所进行的冠切术的结果。在此期间，共进行了63例冠切术。经地区伦理委员会批准后，联系了所有63例患者，共有44例患者同意参与研究。基于全景X线片（OPG）进行影像学分析，并分析患者记录，以评估哪些人口统计学和局部因素与牙根移位以及术后并发症的数量相关。结果：牙根移位与性别、牙根解剖结构或牙齿阻生模式无关。在年龄较小的组（即≤25岁）中，牙根移位的观察频率明显更高。报告了4例术后并发症；其中2例通过全身使用抗生素得到解决，而另外2例需要手术干预以去除剩余牙根。没有报告短暂或永久性神经感觉障碍的病例。结论：冠切术是一种可行的技术，可避免在拔除3M时损伤神经。
