Maxillofac Plast Reconstr Surg.  2017 Oct;39(10):29. 10.1186/s40902-017-0127-z.

Intentional partial odontectomy—a long-term follow-up study

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam City, Gyunggi-do Korea. kyk0505@snubh.org
  • 2Department of Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, Daehak-ro 101, Jongno-gu, Seoul, 03080 Korea.

Abstract

BACKGROUND
The surgical extraction of the third molar is the most frequently encountered procedure in oral and maxillofacial surgery and is related with a variety of complications. This study examined the efficacy of intentional partial odontectomy (IPO) in the third molars which have no periapical lesions and are located near important anatomical structures such as inferior alveolar nerve.
METHODS
Seven patients (four males, three females, 39.1 ± 11.6 years), who received IPO to reduce the risk of inferior alveolar nerve injury (IANI), were followed long-term. The treated teeth were horizontally impacted third molars in the mandibular left (n = 5) or mandibular right (n = 4) areas and were all ankylosed with the surrounding alveolar bone. During the IPO, the bone around the crown was removed to expose the crown, and then the tooth was resected at cement-enamel junction (CEJ). Any secondary trauma to the healthy root was minimized and remained intact after primary suture.
RESULTS
The mean follow-up time was 63.2 ± 29.8 months, and all sites showed good bone healing after the crown removal. Also, sensory abnormality was not found in any patients after IPO. In one patient, the bone fragments erupted 4 months after IPO. In other patient, an implant placed on second molar site adjacent to the third molar that received IPO was explanted about 2 years after the patient's persistent discomfort.
CONCLUSIONS
In case where high risk of IANI exists, IPO may be chosen alternatively to surgical extraction to reduce the risk of nerve damage. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s40902-017-0127-z) contains supplementary material, which is available to authorized users.

Keyword

Hypercementosis; Mandibular nerve; Tooth ankyloses; Tooth extraction

MeSH Terms

Compassion Fatigue
Crowns
Female
Follow-Up Studies*
Humans
Hypercementosis
Male
Mandibular Nerve
Molar
Molar, Third
Surgery, Oral
Sutures
Tooth
Tooth Ankylosis
Tooth Extraction
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