Wisdom tooth extraction is the surgical removal of wisdom tooth. Wisdom tooth is the last erupting tooth in the oral cavity which usually erupts between the age of 17-25 years.

In most of the cases, the wisdom tooth does not have enough space for the eruption. Because of the insufficient space, wisdom tooth often remains impacted and may sometime lead to pain, infection, swelling, etc.

Hence, the dentist often advises the extraction of wisdom tooth to reduce further potential damage.

However, extraction of wisdom tooth may not be favorable in many situations. In a few instances, where nerve damage is suspected with the removal of wisdom teeth, the dentist goes for the coronectomy procedure. Coronectomy is an alternative to wisdom tooth removal.

If you are in a dilemma whether you need to go for extraction of your wisdom tooth or coronectomy, then read ahead in this article to get to the conclusion.

What is coronectomy?

Coronectomy, once known as the partial odontectomy, is the procedure in which the crown portion of the tooth is removed while keeping the healthy roots in its place. On the other hand, the extraction of wisdom tooth involves the complete removal of wisdom tooth.

Coronectomy is the conservative treatment alternative for lower wisdom tooth extraction. Crown of the wisdom tooth act as a source for pericoronitis, tooth decay, food entrapment, etc.

Hence, many such problems associated with wisdom tooth can be prevented by coronectomy. The development of root of lower wisdom tooth approaches the inferior alveolar nerve.

Therefore, the dentist often advises the earlier extraction of lower wisdom even before the root formation to avoid chances of nerve damage during tooth extraction.

When should you consider coronectomy?

Not all the wisdom teeth considered as the trouble. Likewise, not always you need to go for wisdom tooth extraction if there some issues.

If you fear the extraction procedure and have healthy roots, then coronectomy is the best treatment option for you. Despite this fact, you should likely to go for coronectomy in following conditions.

  • If the roots of your lower wisdom tooth are placed near the inferior alveolar nerve in the radiographic picture, then the coronectomy is the best treatment option (1). Extraction of a wisdom tooth is such cases may cause permanent nerve damage.

The close association of roots of the wisdom tooth with the sensory nerve is shown on the radiograph by fewer signs such as narrowing, divergence or interruption of the nerve canal, darkened roots of the tooth, interruption of lamina dura, etc.

  • You can consider coronectomy for vital, caries-free, non-mobile wisdom tooth to avoid the further potential of wisdom tooth infection.

Coronectomy is the successful treatment aid to avoid the infection induced by a wisdom tooth. However, wisdom tooth removal performed in fewer cases such as –

  • If you have a non-vital, carious or infectious wisdom tooth, then the extraction of the wisdom tooth is advised to avoid further spread of infection.
  • If your wisdom tooth is mobile due to poor periodontal health, then consider its removal. Roots should be removed even if they become mobile during the procedure as the loose tooth acts a nidus for infection.
  • You should go for the wisdom tooth removal if you have medically compromised health such as cancer or chronic health condition causing recurrent infections. (2)
  • If you are susceptible to local infections, then consider the wisdom tooth extraction to minimize the oral health risk.
  • If you have already damaged the inferior alveolar nerve, then tooth extraction can be performed. As the area has already lost its sensation and the further nerve damage will cause no harm.
  • If your tooth is horizontally impacted along the inferior alveolar nerve, then the coronectomy may harm the nerve.

Benefits of coronectomy

Often, wisdom tooth lies close to the inferior alveolar nerve and the lingual nerve. These nerves give nerve supply to the tongue, chin, and lower lip. Damage to inferior alveolar nerve or lingual nerve causes numbness, pain and altered sensation of the affected area.

The most probable chances of the inferior alveolar nerve damage noted with wisdom tooth extraction. Coronectomy prevents neuropathy by avoiding the tooth extraction that has the potential of nerve damage.

Hence, the coronectomy procedure acts as the savior of the inferior alveolar nerve. In the coronectomy procedure, the crown of the wisdom tooth is cut and removed by leaving the roots in the socket.

The left out roots will automatically erupt over time as the eruption of the tooth is the continuous phenomenon. When these roots move away from the Inferior alveolar nerve in its eruption process, the extraction of the roots performed by the dentist.

In this way, coronectomy achieve the safest extraction of wisdom tooth placed near to the nerve.

What should you expect after the procedure?

 Coronectomy has the least hazard as compared to the tooth extraction procedure (3). Healing after the procedure is fast as the coronectomy does not open the tooth socket completely.

Post-extraction pain and infection prevented by the analgesics and antibiotics prescribed by the dentist.

Early complication of coronectomy includes dry socket, swelling, recurrent infection, etc. For a patient with the complication of dry socket consider irrigation with chlorhexidine mouthwash followed by application of the resorbable dressing.

Swelling is the most common complication noticed with wisdom tooth procedure. Early application of ice pack in first 24hrs may help.

Restricted mouth opening also noted with the swelling. In such a case, modify your diet if you cannot open your mouth freely. You can switch to soft food and drinks until you get relief.

Early removal of left root pieces considered if the patient develops a recurrent infection after the procedure. Oral hygiene should be maintained to prevent the chances of infection in the wound.

Proper brushing and mouth rinsing with antiseptic mouthwash will help you to dislodge the food particles or debris and keep the area clean.

Final words

Coronectomy is the minimal innervation procedure and the best way to reduce the neurologic complication associated with lower wisdom tooth removal (4). Talk to your dentist if you have any doubts.

If your dentist finds this option suitable for you, then you can go for the coronectomy procedure. Coronectomy considered as the safe procedure with minimal postoperative complication.

The success of the procedure depends on the maintenance of oral hygiene. Postoperative care and follow up minimizes the chances of complications.

Coronectomy is the procedure in which the crown portion of the tooth is removed while keeping the healthy roots in its place.