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<p>Guidelines for Surgical Coronectomies<br>LT Nicole Yates, DC, USN, LT Robert Block, DC, USN, CAPT Jesse Lee, DC, USN and CAPT Timothy Ackerman, DC, USN<br><br>INTRODUCTION<br>Third molar impactions are the most commonly impacted teeth in clinical practice, with prevalence ranging from 35.9% to 58.7%. One theory accounting for the frequent impaction of third molars holds the human diet transitioning from coarse to refined grains accountable for the decreased mesial migration of teeth. Third molar impactions are associated with several pathological changes such as cysts, tumors, caries, and pericoronitis. Practitioners advise patients on the removal of impacted third molars via extraction or coronectomy in the absence of pathology on the basis of prevention; if pathology is present, coronectomy may not be an available treatment option.<br><br>Coronectomy is a surgical procedure, first proposed in 1984 by Ecuyer and Debien, designed to avoid the risk of iatrogenic neurological injury to the inferior alveolar nerve (IAN) by removal of the anatomical crown only, leaving root fragments. IAN injury is a rare, but serious risk associated with removal of third molars, especially impacted third molars. Injury is thought to be due to compression or direct contact by surgical instruments or tooth roots. The resulting sensory deficit may or may not be permanent and has a generally accepted incidence rate of three per-cent. This Clinical Update will discuss the assessment factors integral to determining treatment modality, coronectomy technique, and the possible complications.
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<br>Subjects: Tooth; Impacted;</div>
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U.S. Navy. Naval Postgraduate Dental School</div>
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