APPLICATION OF CORONECTOMY AS AN ALTERNATIVE SURGICAL METHOD FOR THE TREATMENT OF IMPACTED MANDIBULAR THIRD MOLARS - A CASE REPORT

Albina AJETI ABDURAMANI, Boris VELICKOVSKI, Fjolla AJETI

Abstract

The extraction of mandibular third molar is a difficult surgical approach, because of the close relation of the tooth to the inferior alveolar nerve. Coronectomy can be applied as an alternative technique instead, in order to avoid inferior alveolar nerve damage and its sensitivity changes. Removing the crown of mandibular third molar and leaving the roots intact, reduces the risk of nerve injury and postoperative neurosensory deficits. Specific radiographic signs have been identified to enable appropriate surgical approach; however, CBCT is considered as a more effective imaging technique, allowing better decisions to be made with regards to the removal technique. This case report demonstrates the complex surgical approach to managing the impacted third mandibular molar of a 24 years old female patient, where the roots of the tooth are in a close proximity to the inferior alveolar nerve. The patient was followed up for a 12-month period, where a clinical, CBCT and radiographic evaluation was made. No discomfort of the patient was registered after the surgery, neither deficit in sensitive nerve function for the anticipated follow-up period. Coronectomy reduces the incidence of complications related to the inferior alveolar nerve, although it does not completely exclude the possibility of complications of another nature related to the subsequent migration of the roots.

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