Coronectomy root retrievals: a review of 92 cases.
Journal
Oral surgery, oral medicine, oral pathology and oral radiology
ISSN: 2212-4411
Titre abrégé: Oral Surg Oral Med Oral Pathol Oral Radiol
Pays: United States
ID NLM: 101576782
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
received:
17
07
2018
revised:
26
08
2018
accepted:
03
09
2018
pubmed:
13
10
2018
medline:
28
1
2020
entrez:
13
10
2018
Statut:
ppublish
Résumé
Coronectomy has become an increasingly prescribed surgical treatment for mandibular third molars that are deemed to pose a risk to the inferior dental nerve. Retention of the roots poses a risk of need for root retrieval in the future if symptoms are present. Long-term outcomes and the symptoms that lead to root retrieval via coronectomy have not been well documented or studied, and this has understandably led to hesitation in some clinicians in offering the procedure. The current series assesses patients who have undergone root retrieval, their reported indications for removal, and the histopathologic status of the removed roots. A total of 92 cases of root retrievals via coronectomy carried out at Guy's Dental Hospital are included in this analysis. Data were collected retrospectively from patient records regarding patient symptoms, clinical and radiographic findings, function of the inferior dental nerve, and histologic results. The mean age of patients in the study group was 31.6 years (range 19-70 years), with a female-to-male ratio of 62:18 (77.5% female). Mean time to the second surgery for root retrieval was 17 months. In "successfully" performed coronectomies, 75.3% (61 of 81) of root pulps appeared vital histopathologically. Mucosal tenderness (39 of 81 [48.1%]) was the most common symptom leading to root retrieval. Root retrieval after coronectomy should be based on findings from sound clinical and radiographic examinations. In the presence of obvious indications, such as an unhealed socket resulting from retained enamel or soft tissue infection after eruption of roots, then retrieval should be performed with confidence that resolution would occur. However, if the coronectomy root appears an unlikely culprit, then the clinician should consider and investigate alternative diagnoses, such as overerupted upper third molars causing trauma, temporomandibular dysfunction, and the dental status of the adjacent tooth as potential causes of symptoms.
Sections du résumé
BACKGROUND
BACKGROUND
Coronectomy has become an increasingly prescribed surgical treatment for mandibular third molars that are deemed to pose a risk to the inferior dental nerve. Retention of the roots poses a risk of need for root retrieval in the future if symptoms are present. Long-term outcomes and the symptoms that lead to root retrieval via coronectomy have not been well documented or studied, and this has understandably led to hesitation in some clinicians in offering the procedure. The current series assesses patients who have undergone root retrieval, their reported indications for removal, and the histopathologic status of the removed roots.
STUDY DESIGN
METHODS
A total of 92 cases of root retrievals via coronectomy carried out at Guy's Dental Hospital are included in this analysis. Data were collected retrospectively from patient records regarding patient symptoms, clinical and radiographic findings, function of the inferior dental nerve, and histologic results.
RESULTS
RESULTS
The mean age of patients in the study group was 31.6 years (range 19-70 years), with a female-to-male ratio of 62:18 (77.5% female). Mean time to the second surgery for root retrieval was 17 months. In "successfully" performed coronectomies, 75.3% (61 of 81) of root pulps appeared vital histopathologically. Mucosal tenderness (39 of 81 [48.1%]) was the most common symptom leading to root retrieval.
CONCLUSIONS
CONCLUSIONS
Root retrieval after coronectomy should be based on findings from sound clinical and radiographic examinations. In the presence of obvious indications, such as an unhealed socket resulting from retained enamel or soft tissue infection after eruption of roots, then retrieval should be performed with confidence that resolution would occur. However, if the coronectomy root appears an unlikely culprit, then the clinician should consider and investigate alternative diagnoses, such as overerupted upper third molars causing trauma, temporomandibular dysfunction, and the dental status of the adjacent tooth as potential causes of symptoms.
Identifiants
pubmed: 30309828
pii: S2212-4403(18)31164-7
doi: 10.1016/j.oooo.2018.09.001
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
200-209Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.