What is a coronectomy?
A coronectomy is a dental surgical procedure to remove the crown of the wisdom tooth while leaving behind the roots of the tooth, preserving the nerve endings. It is performed on wisdom teeth in the lower jaw that are impacted but cannot be entirely removed due to the risk of nerve damage.
When is a coronectomy needed?
Wisdom teeth, also known as the third molars, are the last teeth to emerge, usually during adolescence to early adulthood. It is a common issue that there is not enough space to accommodate them in what is known as ‘crowding’, and thus they are considered to be ‘impacted’, which can cause issues such as pain, decay, cysts, and pressure on the other teeth, necessitating the wisdom tooth’s removal. However, in some cases, the wisdom tooth is positioned near a nerve in the jawbone, the inferior alveolar nerve, which provides sensation to the lower lip, gums, tongue, cheeks, and chin.
A coronectomy is recommended when the oral X-ray scan results show that the wisdom tooth, which is impacted, painful, or causing infection, has roots that are too close to the nerve, and so extracting the tooth entirely would be very complex and put the nerve at risk of damage. A coronectomy is not a guarantee that there will not be any nerve-related complications following the procedure, but it significantly lowers the chances, especially when compared to a full extraction.
What happens during a coronectomy?
A coronectomy is performed under a local anaesthetic, though nervous or anxious patients can request sedation. The procedure involves the surgeon or dentist making a small incision in the gum, which exposes the crown of the wisdom tooth. The crown is then removed with a drill, and the remains of the tooth are smoothed over without disturbing the roots. The gum is then put back into position and sutured shut for healing. The whole procedure takes less than an hour, and patients can go home once the anaesthetic or sedation has worn off.
If the roots do shift or move or become exposed during the procedure, then it is possible that the whole tooth, roots included, needs to be removed. There is also a chance of future root infection, necessitating their removal. This can occur in around 15 per cent of cases.
What happens after a coronectomy?
Recovering from a coronectomy is shorter than from a full wisdom tooth extraction, and typically takes up to a month, with patients expected to return to normal activities within a few days.
Mild swelling, aching, and discomfort are common for the initial days after the procedure, which can be alleviated with pain relief medicines and cold compresses. As the incision is in the mouth, soft foods are recommended while the wound heals to avoid disrupting the sutures. The dentist will give further care instructions, which may include salt water rinses or antiseptic mouthwash to prevent post-procedure infection.
Patients will have a follow-up visit with their dentist or surgeon after a couple of weeks so that they may assess the recovery progress and remove sutures if they are not the dissolvable kind.
