J-C Bernabeu-Mira, D Peñarrocha-Oltra, M Peñarrocha-Diago
{"title":"影响下颌第三磨牙的冠状切除术:临床和放射学回顾性病例系列研究,随访 2-9 年。","authors":"J-C Bernabeu-Mira, D Peñarrocha-Oltra, M Peñarrocha-Diago","doi":"10.4317/medoral.26159","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Impacted mandibular third molars occasionally are in intimate relation to the inferior alveolar nerve (IAN). Coronectomy has been proposed as a good alternative to prevent injury of the IAN. The present study evaluates the clinical and radiological outcomes of impacted mandibular third molars presenting radiographic signs associated with a high risk of IAN injury, and which were treated with the coronectomy technique.</p><p><strong>Material and methods: </strong>A retrospective case series evaluated the outcomes of coronectomies of impacted mandibular third molars. The inclusion criteria were: available preoperative, immediate postoperative and two-year panoramic radiographs, preoperative cone-beam computed tomography (CBCT), and a complete case history. The clinical evaluation comprised intraoperative complications (mobilized fragments of root and damage to adjacent structures), short-term complications (sensory alterations and postoperative infection), and long-term complications (infection or oral exposure). The IAN position with respect to the roots, root shape, eruption status, third molar position, radicular-complex migration and bone above roots were radiographically evaluated as well.</p><p><strong>Results: </strong>Approximately a total of 2000 mandibular third molars were removed from 2011 to 2022. Of these, 39 molars in 34 patients were partially extracted using the coronectomy technique. The mean age was 36 years (range 22-77), and the mean follow-up was 28 months (range 24-84). There were two short-term postoperative infections. One of them was resolved through reintervention to remove the roots after antibiotic treatment, while the other required hospital admission and removal of the roots. One case of short-term transient lingual paresthesia was also recorded. Two long-term oral exposures were detected, and the root fragments had to be extracted. There were no permanent sensory alterations.</p><p><strong>Conclusions: </strong>In our case series of 39 impacted mandibular molars in intimate contact with the IAN and treated with the coronectomy technique, the number of complications was low (two infections and a single case of transient lingual paresthesia), and no permanent sensory alterations were observed. Prospective studies, especially randomized clinical trials, are needed to compare this technique with conventional extraction.</p>","PeriodicalId":18351,"journal":{"name":"Medicina oral, patologia oral y cirugia bucal","volume":" ","pages":"e180-e186"},"PeriodicalIF":2.2000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10945869/pdf/","citationCount":"0","resultStr":"{\"title\":\"Coronectomy of impacted mandibular third molars: a clinical and radiological retrospective case series study with 2-9 years of follow-up.\",\"authors\":\"J-C Bernabeu-Mira, D Peñarrocha-Oltra, M Peñarrocha-Diago\",\"doi\":\"10.4317/medoral.26159\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Impacted mandibular third molars occasionally are in intimate relation to the inferior alveolar nerve (IAN). Coronectomy has been proposed as a good alternative to prevent injury of the IAN. The present study evaluates the clinical and radiological outcomes of impacted mandibular third molars presenting radiographic signs associated with a high risk of IAN injury, and which were treated with the coronectomy technique.</p><p><strong>Material and methods: </strong>A retrospective case series evaluated the outcomes of coronectomies of impacted mandibular third molars. The inclusion criteria were: available preoperative, immediate postoperative and two-year panoramic radiographs, preoperative cone-beam computed tomography (CBCT), and a complete case history. The clinical evaluation comprised intraoperative complications (mobilized fragments of root and damage to adjacent structures), short-term complications (sensory alterations and postoperative infection), and long-term complications (infection or oral exposure). The IAN position with respect to the roots, root shape, eruption status, third molar position, radicular-complex migration and bone above roots were radiographically evaluated as well.</p><p><strong>Results: </strong>Approximately a total of 2000 mandibular third molars were removed from 2011 to 2022. Of these, 39 molars in 34 patients were partially extracted using the coronectomy technique. The mean age was 36 years (range 22-77), and the mean follow-up was 28 months (range 24-84). There were two short-term postoperative infections. One of them was resolved through reintervention to remove the roots after antibiotic treatment, while the other required hospital admission and removal of the roots. One case of short-term transient lingual paresthesia was also recorded. Two long-term oral exposures were detected, and the root fragments had to be extracted. There were no permanent sensory alterations.</p><p><strong>Conclusions: </strong>In our case series of 39 impacted mandibular molars in intimate contact with the IAN and treated with the coronectomy technique, the number of complications was low (two infections and a single case of transient lingual paresthesia), and no permanent sensory alterations were observed. Prospective studies, especially randomized clinical trials, are needed to compare this technique with conventional extraction.</p>\",\"PeriodicalId\":18351,\"journal\":{\"name\":\"Medicina oral, patologia oral y cirugia bucal\",\"volume\":\" \",\"pages\":\"e180-e186\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10945869/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medicina oral, patologia oral y cirugia bucal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4317/medoral.26159\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medicina oral, patologia oral y cirugia bucal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4317/medoral.26159","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Coronectomy of impacted mandibular third molars: a clinical and radiological retrospective case series study with 2-9 years of follow-up.
Background: Impacted mandibular third molars occasionally are in intimate relation to the inferior alveolar nerve (IAN). Coronectomy has been proposed as a good alternative to prevent injury of the IAN. The present study evaluates the clinical and radiological outcomes of impacted mandibular third molars presenting radiographic signs associated with a high risk of IAN injury, and which were treated with the coronectomy technique.
Material and methods: A retrospective case series evaluated the outcomes of coronectomies of impacted mandibular third molars. The inclusion criteria were: available preoperative, immediate postoperative and two-year panoramic radiographs, preoperative cone-beam computed tomography (CBCT), and a complete case history. The clinical evaluation comprised intraoperative complications (mobilized fragments of root and damage to adjacent structures), short-term complications (sensory alterations and postoperative infection), and long-term complications (infection or oral exposure). The IAN position with respect to the roots, root shape, eruption status, third molar position, radicular-complex migration and bone above roots were radiographically evaluated as well.
Results: Approximately a total of 2000 mandibular third molars were removed from 2011 to 2022. Of these, 39 molars in 34 patients were partially extracted using the coronectomy technique. The mean age was 36 years (range 22-77), and the mean follow-up was 28 months (range 24-84). There were two short-term postoperative infections. One of them was resolved through reintervention to remove the roots after antibiotic treatment, while the other required hospital admission and removal of the roots. One case of short-term transient lingual paresthesia was also recorded. Two long-term oral exposures were detected, and the root fragments had to be extracted. There were no permanent sensory alterations.
Conclusions: In our case series of 39 impacted mandibular molars in intimate contact with the IAN and treated with the coronectomy technique, the number of complications was low (two infections and a single case of transient lingual paresthesia), and no permanent sensory alterations were observed. Prospective studies, especially randomized clinical trials, are needed to compare this technique with conventional extraction.
期刊介绍:
1. Oral Medicine and Pathology:
Clinicopathological as well as medical or surgical management aspects of
diseases affecting oral mucosa, salivary glands, maxillary bones, as well as
orofacial neurological disorders, and systemic conditions with an impact on
the oral cavity.
2. Oral Surgery:
Surgical management aspects of diseases affecting oral mucosa, salivary glands,
maxillary bones, teeth, implants, oral surgical procedures. Surgical management
of diseases affecting head and neck areas.
3. Medically compromised patients in Dentistry:
Articles discussing medical problems in Odontology will also be included, with
a special focus on the clinico-odontological management of medically compromised patients, and considerations regarding high-risk or disabled patients.
4. Implantology
5. Periodontology