Intentional partial odontectomy and effect on inferior alveolar nerve injuries: a systematic review
Clinical Snapshot
PICO Framework
| P — Population | Patients requiring mandibular third molar surgery with radiographic proximity to the inferior alveolar nerve |
| I — Intervention | Coronectomy (intentional partial odontectomy) |
| C — Comparator | Complete extraction of mandibular third molars |
| O — Outcomes | Neurosensory complications (inferior alveolar nerve injury), postoperative complications, root migration |
Bottom Line
This systematic review suggests coronectomy offers a safer alternative to complete extraction for mandibular third molars in close proximity to the inferior alveolar nerve, significantly reducing neurosensory complications. While root migration is common post-coronectomy, it rarely causes clinical problems. The evidence supports considering coronectomy in high-risk cases, but careful patient selection and long-term follow-up are essential. However, the abstract lacks crucial methodological details and quantitative results needed for full critical appraisal. Clinicians should await the full paper for comprehensive evidence evaluation before changing practice protocols.
Key Findings
P Value: Not reported in abstract
Effect Size: Significantly reduced with coronectomy (specific measures not provided in abstract)
Primary Outcome: Inferior alveolar nerve injury risk
Nnt Or Sensitivity: Not calculable from available data
Confidence Interval: Not reported in abstract
Clinical Application
Requires surgical expertise in coronectomy technique and appropriate case selection Relevant to Australian oral and maxillofacial surgeons; technique may require specific training and should align with ANZAOMS guidelines for third molar surgery Patients requiring mandibular third molar surgery with radiographic evidence of IAN proximity
Abstract
OBJECTIVES: To synthesize current evidence comparing coronectomy (intentional partial odontectomy) and complete extraction of mandibular third molars in close radiographic proximity to the inferior alveolar nerve, focusing on neurosensory complications and other clinically relevant postoperative outcomes. DATA SOURCES: PubMed, Scopus, and Google Scholar databases were manually searched using strings combining terms such as 'coronectomy,' 'partial odontectomy,' 'root retention,' 'mandibular third molar,' 'extraction,' and 'inferior alveolar nerve injury.' Searches were conducted in accordance with PRISMA 2020 guidelines. CONCLUSION: Coronectomy significantly reduces the risk of inferior alveolar nerve injury in mandibular third molar surgery compared to extraction in cases with inferior alveolar nerve proximity. The main drawback to this technique is subsequent root migration, which is common but rarely clinically problematic. Careful patient selection and follow-up are essential in selecting this procedure.
References
- 1.Brudner, B., Jacobs, T., & Ziccardi, V. B. (2026). Intentional partial odontectomy and effect on inferior alveolar nerve injuries: a systematic review. Quintessence International, advance online publication. https://doi.org/10.3290/j.qi.b6912877
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