How do we review coronectomies? A national survey

Abstract

Coronectomy of a mandibular third molar is a surgical procedure which aims to protect the inferior alveolar nerve (IAN) by removing the crown of the tooth, whilst leaving the roots in‐situ. There is an anecdotal variation in practice regarding the post‐operative clinical and radiographic review of patients who have undergone this procedure, which may be attributable to a lack of high‐quality evidence or guidance. The aim of this study was to establish current practice within the United Kingdom (UK) for a post‐operative review following a coronectomy.An online survey was distributed to 50 Oral Surgery speciality registrars working within Oral Surgery and Oral and Maxillofacial departments across the UK during June 2022. Two reminder emails were sent, and participants were asked to respond on behalf of their departments.Twenty responses were received from trainees, on behalf of 20 separate departments. Fifty percent (n = 10) of the responding departments discharged patients without intra‐operative complications immediately following the procedure. The remaining 50% of departments discharged patients at points ranging from 2 weeks to 12 months. Departments who review patients who have undergone a coronectomy without intra‐operative complications do so between 1 and 3 times, with the most common time for the first review being at 1‐month post‐procedure (n = 3). When reviewing these patients, 54.5% (n = 6) of departments utilise face‐to‐face only reviews, whereas 36.4% (n = 4) of departments utilise a combination of face‐to‐face and remote reviews. Sixty‐five percent (n = 13) of departments do not routinely take postoperative imaging for these patients. Many departments also reported variation in practice within their departments, regarding discharge timing, clinical review and radiographic review.This survey has suggested that there is variation in practice within the secondary and tertiary care Oral Surgery and Oral and Maxillofacial Surgery centres within the United Kingdom in relation to the post‐operative clinical and radiographic coronectomy review. Consideration should be given to further high‐quality research into these areas, including the merits of patient‐initiated reviews and the development of guidelines for post‐operative management of coronectomy patients.