Intentional coronectomy: case report

Abstract

ABSTRACT

Introduction: The impaction of the lower third molar is a common condition that may require prophylactic surgical removal due to complications such as caries and periodontal disease. However, when the roots of these teeth are near to the Inferior Alveolar Nerve, complete removal may cause damage, resulting in paresthesia. In such cases, intentional coronectomy, which involves the removal of the tooth crown and preservation of the root, emerges as a viable alternative. Objective: This report aims to describe a clinical case of an intentional coronectomy procedure, justifying its choice based on scientific evidence addressing alternatives for the removal of lower third molars in close contact with the inferior alveolar nerve. Case report: A female patient in her third decade of life sought treatment with an indication for the removal of the lower right third molar. Imaging evaluation revealed that the roots of teeth 38 and 48 were in close contact with the inferior alveolar nerve. Therefore, the treatment of choice was intentional coronectomy of tooth 48. The surgery was performed through a triangular flap, initiated in the retromolar region, followed by the distal region of the second molar and intragumularly on the vestibular aspect of the same tooth, finalized with a relaxing incision on the mesial third of the second molar gingiva. Osteotomy was then performed, followed by odontosection, allowing the separation of the crown. The area was thoroughly irrigated with sterile saline, and the incision was sutured with simple stitches. Conclusions: In this case report, none of the potential complications or intercurrences mentioned by some authors occurred, supporting the success rate of coronectomy presented in the literature when appropriately indicated and executed.

Keywords: Mandibular Nerve; Paresthesia; Molar, Third.