Coronectomy as an alternative technique to complete extraction of mandibular third molars with risk of nerve injury

Sep 28, 2026

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Extraction of mandibular third molars is among the most common oral surgery procedures, yet it carries important risks, especially injury to the inferior alveolar nerve (IAN). This systematic review compares coronectomy with conventional extraction in cases with high IAN-injury risk to evaluate whether coronectomy is an effective alternative. A literature search (PubMed and Cochrane) identified 211 studies, with 16 included (2551 patients).

LanguageEnglish

CategoryHealthcare

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Pages12

Reading Time30 min

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Abstract

Background

Material and Methods

Results

Conclusions

Introduction

Med Oral Patol Oral Cir Bucal. 2026 Jan 1;31 (1):e19-30 . Coronectomy as an alternative technique in mandibular third molars Journal section: Oral Surgery doi:10.4317/medoral.27459 Publication Types: Review Coronectomy as an alternative technique to complete extraction of mandibular third molars with risk of nerve injury Laura Rico-Barroso 1, María-Encarnación Barroso-Medel 2, José-Luis Gutiérrez-Pérez 1, María-Ángeles Serrera-Figallo 1, Daniel Torres-Lagares 1 1 University of Seville, Faculty of Dentistry. C/Avicena, s/n, 41009 Seville, Spain 2 Dr Balmis University General Hospital, Av. Pintor Baeza 12, 03010, Alicante, Spain Correspondence: University of Seville, Faculty of Dentistry C/Avicena, s/n, 41009 Seville, Spain [danieltl@us.es](danieltl@us.es) [Received: 14/04/2025](Received: 14/04/2025) [Accepted: 18/09/2025](Accepted: 18/09/2025) Rico-Barroso L, Barroso-Medel ME, Gutiérrez-Pérez JL, Serrera-Figallo MA, Torres-Lagares D. Coronectomy as an alternative technique to complete extraction of mandibular third molars with risk of nerve injury. Med Oral Patol Oral Cir Bucal. 2026 Jan 1;31 (1):e19-30 . Article Number:27459 [http://www.medicinaoral.com/](http://www.medicinaoral.com/) © Medicina Oral S. L. C.I.F. B 96689336-pISSN 1698-4447-eISSN: 1698-6946 eMail: medicina@medicinaoral.com Indexed in: Science Citation Index Expanded Journal Citation Reports Index Medicus, MEDLINE, PubMed Scopus, Embase and Emcare Indice Médico Español Abstract Background: Extraction of mandibular third molars (MTM) is one of the most frequent surgical procedures in Oral Surgery. This intervention is not without risks, as one of the most common is an injury of the inferior alveolar nerve (IAN). The main objective of this systematic review is to compare the coronectomy technique with conventional extraction of MTM with a high risk of injury to the IAN, thus determining whether coronectomy is an effective surgical alternative in preventing nerve injuries. Material and Methods: A bibliographical search was conducted in October 2024 in the Pub-Med and CochraneDatabase databases, and 211 studies were obtained. Finally, 16 studies were included in the systematic review, with a total sample of 2551 patients. 2280 coronectomy procedures and 841 extractions were performed. Results: 6.22% of the coronectomies performed were unsuccessful. The incidence of IAN injury was 6.53% in the extraction group, while in the coronectomy group, it was only 0.56%. Permanent IAN injury was 1.18% and 0.13%, respectively. The most common complication in both groups was postoperative pain, with similar results, 15.69% in the extraction group vs. 14.21% in the coronectomy group. Lingual nerve injury was infrequent and transient in both groups, affecting 0.12% of extractions and 0.26% of coronectomies. The complication with the highest incidence in the coronectomy group was root migration, mainly during the first 6 months. Conclusions: Coronectomy is a safe and effective alternative technique for the management of MTM with a high risk of IAN injury. Keywords: Coronectomy, mandibular third molar, inferior alveolar nerve. Introduction Because 35.9% and 58.7% of the general population have at least one impacted third molar, impacted third molars, especially mandibular ones, are a relatively common cause of pain and inflammation in the oral region [1,2]. These impacted molars also have a well-documented associated pathology: Cysts, tumors, caries, and pericoronitis are among the most common pathologies, which leads to the need for extraction treatment in most of these cases [3]. Surgical extraction of mandibular third molars is a standard procedure; however, it is not exempt from postoperative complications, such as pain, trismus, swelling, and general oral discomfort, which usually subside within a few days. Furthermore, although less frequently, the anatomical proximity of the mandibular third molar (MTM) to the inferior alveo

FAQs

What is the main purpose of this systematic review?

To compare the coronectomy technique with conventional extraction of mandibular third molars that carry a high risk of injury to the inferior alveolar nerve, assessing whether coronectomy helps prevent nerve injuries.

How was the evidence collected and how many studies were included?

A bibliographical search was performed in October 2024 in PubMed and Cochrane databases, yielding 211 studies. Finally, 16 studies were included, totaling 2551 patients.

What were the reported outcomes for IAN injury between techniques?

The incidence of IAN injury was 6.53% with extraction and 0.56% with coronectomy. Permanent IAN injury was 1.18% for extraction versus 0.13% for coronectomy.

Sep 28, 2026

Uploaded by Asher