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Coronectomy: An Alternative To Wisdom Teeth Extraction

Wisdom teeth are notorious for being impacted and needing removal. They sit way at the back in your mouth, so they often don't have enough room to erupt properly. If your dentist or oral surgeon has suggested extracting your wisdom teeth, but then tells you a coronectomy might be a better option, here's why and what you need to know about the procedure.

Nerve Complications

The roots of wisdom teeth in the lower jaw often press on or wrap around the nerves that supply feeling to your tongue, lip and chin. When the roots are close to either the lingual nerve (LN) or the inferior alveolar nerve (IAN), research published in Head & Face Medicine warns that surgical extraction may cause nerve damage, leaving you with temporary or permanent loss of feeling.

Damage to the LN or IAN often interferes with speaking, eating and general quality of life. In the case of trauma to the LN, there may be a loss of taste, according to a case report in the Journal of Medical Case Reports. So, if after assessing your X-rays, your dentist determines that the roots of your wisdom teeth are too close to the nerves to avoid injury, he or she may suggest an alternative to a traditional wisdom tooth extraction.

Coronectomy Procedure

This treatment involves removing the crown of the tooth and leaving the roots intact in your jaw. Although the roots may have viable pulp tissue, pupal therapy isn't necessary as the roots will heal over with bone and eventually move away from the nerve. An analysis published in Dental Update concludes that when roots are within the immediate vicinity of the IAN, a coronectomy is preferable to extraction as a means to preventing neurological damage.

A study in the Journal of Oral and Maxillofacial Surgery explains that a small percentage of people may later need to have the retained roots extracted because they have begun to erupt. But if this happens, the roots will be far enough away from the IAN that the extraction will not harm the nerve.

Who's a Good Candidate?

Your oral surgeon will be the best judge of whether a coronectomy is an option for your condition, but it would only be recommended if the roots of your tooth are close to the nerves. There are a few other situations when this procedure would not be advisable.

  • Tooth and/or root is infected.
  • Tooth is mobile or root mobility is discovered during surgery.
  • Tooth is horizontally impacted along the IAN (sectioning the tooth would injure the nerve).
A study published in the Journal of the American Dental Association promotes a coronectomy as a good alternative in patients older than 40, since they are at a higher risk of suffering nerve damage. Extracting wisdom teeth at a younger age, before the roots are fully formed, can eliminate not only problems with nerve injury, but prevent damage to the molars in front of them, according to the Academy of General Dentistry.

What to Expect After Surgery

You may have some swelling after the procedure, but it won't be as dramatic as with traditional extractions. The risk of dry socket and post-operative infections is also greatly reduced. Your dentist may prescribe antibiotics, both before and after surgery, and you'll want to follow after-care instructions.

Even though your mouth may be tender, you still need to brush. Brush twice a day with a soft toothbrush, like the Colgate Wave Gum Comfort, to avoid aggravating the wound. This toothbrush has curved, soft outer bristles to clean gum margin and firmer inner bristles to effectively clean teeth. Keep your scheduled follow-up dental appointments and call your dentist if you are having any unusual discomfort.

Whether permanent or temporary, no one wants to lose feeling in any part of his or her mouth or face. So, if your dentist has discussed removing your wisdom teeth, be sure to ask if a coronectomy would be a good alternative procedure for you.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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