Coronectomy - Partial Wisdom Tooth Removal

Last updated: 10th October 2024

A coronectomy is a surgical procedure performed to remove only the crown (top portion) of a tooth, usually a wisdom tooth, while leaving the roots intact. This procedure is often recommended as an alternative to a full tooth extraction, especially when the roots are located very close to vital structures, such as the inferior alveolar nerve, which runs through the lower jaw.

Speak to a dentist about coronectomies

Why Is a Coronectomy Done?

A coronectomy is typically recommended when there is a high risk of nerve damage from a complete extraction, which can result in numbness, tingling, or even permanent loss of sensation in parts of the face, lips, or tongue. The procedure is primarily done on wisdom teeth that are impacted or have roots that are near the inferior alveolar nerve. By leaving the roots intact, the risk of nerve injury is greatly reduced.

Here are common reasons a coronectomy might be suggested:

Wisdom tooth proximity to nerves: If a wisdom tooth’s roots are very close to the mandibular nerve, full extraction could cause nerve damage.
Complicated root structure: Some teeth have roots that are deeply embedded or shaped in a way that makes full removal risky.

How Is a Coronectomy Performed?

A coronectomy is a straightforward surgical procedure, often performed under local anaesthesia. Here's a step-by-step outline of what you can expect:

Initial Examination: Your dentist will carry out an X-ray or 3D (CBCT) scan to evaluate the position of your wisdom tooth, especially the roots.
Anesthesia: Local anaesthesia is administered to numb the area.
Surgical Access: A small incision is made in the gum to expose the wisdom tooth.
Removing the Crown: The crown of the tooth is cut and removed. The roots are left in place to avoid damaging surrounding nerves.
Closure: The gum is stitched back up to promote healing.
Post-Procedure: You will receive instructions on caring for the surgical site as it heals.

Aftercare and Healing

Healing after a coronectomy is similar to a regular tooth extraction, but since the roots are left behind, your recovery may feel different. Here are key aspects of aftercare:

Pain Management: Some discomfort or swelling is expected, which can be managed with prescribed painkillers and anti-inflammatory medication.
Oral Hygiene: Follow your dentist’s advice on cleaning the area to prevent infection. Use a gentle rinse, such as saltwater, to keep the surgical site clean after 24 hours
Soft Foods: Stick to soft foods for a few days to avoid irritating the surgical site.
Healing Time: It generally takes a few weeks for the area to fully heal, though your dentist will monitor the roots over time to ensure no further treatment is necessary.

What Are the Risks of a Coronectomy?

Like any surgical procedure, coronectomies carry some risks. Possible risks include:

Infection: As with any oral surgery, there’s a small risk of infection. However, antibiotics and proper care can minimise this risk.
Root Migration: In some cases, the roots left behind may slowly move away from the nerve. If they begin to surface through the gum, further treatment may be needed such as extracting them.
Dry Socket: This painful condition can occur if the blood clot at the surgery site dislodges, though it is less common after a coronectomy compared to full extractions.

Is a Coronectomy Right for You?

Not every patient with impacted wisdom teeth is a candidate for a coronectomy. It is usually reserved for situations where the risk of nerve damage is high. Your dentist or oral surgeon will evaluate your specific case to determine whether a coronectomy is the safest and most appropriate course of action.

Conclusion

A coronectomy offers a safer alternative for patients whose wisdom teeth pose a risk to the surrounding nerves. If you're concerned about the risks of a full extraction or have been advised that your wisdom tooth roots are in a delicate position, talk to your dentist about whether a coronectomy is a suitable option for you.

For more personalised advice or to schedule a consultation, please contact our onlin denitsts below. We're here to guide you through the process and ensure your treatment is as safe and comfortable as possible.

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