Coronectomy:
A safe treatment for dangerous wisdom teeth
The nerve that gives the sensation to the lower lip is often in contact with the tip of the wisdom tooth, and in these cases extractions can cause nerve damage and loss of sensation - reminiscent of the feeling after a local anesthetic injection.
The numbness can be permanent or temporary, and although most of the time sensation will return over time, sometimes the numbness may remain permanently.
In our practice we advocate a treatment designed to circumvent this complication - a surgery called coronectomy.
The treatment is performed under local anesthesia or sedation, and involves removing the upper part of the tooth while leaving its deep part (the part that may endanger the continuity of the nerve and cause sensory disturbances).
The chance of sensory damage after a coronatomy is very low because the part of the tooth that touches the nerve (the part that can lead to sensory damage during its removal) is proactively left in place.
Over time, in the vast majority of patients the remnant of the tooth left behind will actually be covered with new bone and remain buried forever. We tend to follow the remaining root of the tooth using an X-ray taken about half a year after treatment, to ensure that everything is ok.
In a minority of cases, inflammation or infection will develop near the part of the root left behind. In these cases there will be no alternative to reenter the area in order to remove the tooth left behind. (The good news is that by the time the infection develops the tooth can move away from the nerve, so at this point the treatment is likely to be safer).
Coronectomy necessitates that the surgeon is skill and experience with this procedure, as there are certain constraints that may arise during the surgery that will require the extraction of the entire tooth.
It is important to note that this treatment is not intended for every impacted wisdom tooth - but only for those teeth in which there is a high probability of nerve damage following their removal.