Staged Crown-Root Segmentation Extraction of an Impacted Mandibular Third Molars Adjacent to the Inferior Alveolar Nerve: A Case Report

doi:10.12337/zgkqjxjyzz.2025.03.008

Chinese Journal of Stomatological Continuing Education ›› 2025, Vol. 28 ›› Issue (3): 166-172.DOI: 10.12337/zgkqjxjyzz.2025.03.008

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Staged Crown-Root Segmentation Extraction of an Impacted Mandibular Third Molars Adjacent to the Inferior Alveolar Nerve: A Case Report

Yihang Li¹, Tianshuo Yuan², Peisong Meng^1,*

¹Department of Stomatology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, P.R. China;
²Department of Oral and Maxillofacial Surgery, The Stomatological Hospital of Harbin, Harbin, Heilongjiang Province, P.R. China

Online:2025-05-31 Published:2025-05-31
Contact: Peisong Meng. Tel: 0451-82576565. Email: mengpeisong641205@163.com. Address: No.37 Yiyuan Street, Nangang District, Harbin 150001, Heilongjiang Province, P.R. China.
About author:^#These authors contibute equally to this manuscript.

Abstract

Abstract: Objective: This article reports a case of staged extraction of impacted mandibular third molars adjacent to the inferior alveolar nerve canal (IANC) using coronectomy, providing additional therapeutic options for minimally invasive management of high-risk impacted teeth. Diagnosis and treatment: A 27-year-old male patient presented with bilateral mesioangular low-position impacted mandibular third molars, with roots closely adjacent to the IANC. After discussing postoperative risks of conventional extraction, the patient exhibited severe anxiety. A staged coronectomy protocol was therefore implemented as an adaptive treatment strategy. Results: Following staged extraction, the patient exhibited no postoperative sensory abnormalities, infections, or other complications, with significantly reduced anxiety levels. Conclusions: The procedure of segmental extraction of impacted molars can serve as an alternative treatment option for the removal of mandibular third molars adjacent to the inferior alveolar nerve.

Key words: coronectomy, impacted mandibular third molar, inferior alveolar nerve injury, minimally invasive tooth extraction, tooth root migration

Yihang Li, Tianshuo Yuan, Peisong Meng. Staged Crown-Root Segmentation Extraction of an Impacted Mandibular Third Molars Adjacent to the Inferior Alveolar Nerve: A Case Report[J]. Chinese Journal of Stomatological Continuing Education, 2025, 28(3): 166-172.

References

[1] Céspedes-Sánchez JM, Ayuso-Montero R, Marí-Roig A, et al.The importance of a good evaluation in order to prevent oral nerve injuries: a review[J]. Acta Odontol Scand, 2014, 72(3):161-167.
[2] 吴幸晨, 李颖, 赵隽隽. 冠根分次去除法在疑或累及下牙槽神经的下颌第三阻生磨牙拔除术中的应用[J]. 上海口腔医学, 2019, 28(1):85-88.
[3] Cervera-Espert J, Pérez-Martinez S, Cervera-Ballester J, et al.Coronectomy of impacted mandibular third molars: A meta-analysis and systematic review of the literature[J]. Med Oral Patol Oral Cir Bucal, 2016, 21(4):e505-e513.
[4] Martin A, Perinetti G, Costantinides F, et al.Coronectomy as a surgical approach to impacted mandibular third molars: a systematic review[J]. Head Face Med, 2015, 11:9.
[5] Mukherjee S, Vikraman B, Sankar D, et al. Evaluation of outcome following coronectomy for the management of mandibular third molars in close proximity to inferior alveolar nerve[J]. J Clin Diagn Res, 2016, 10(8):ZC57-ZC62.
[6] Agbaje JO, Heijsters G, Salem AS, et al.Coronectomy of deeply impacted lower third molars: Incidence of outcomes and complications after one year follow-up[J]. J Oral Maxillofac Res, 2015, 6(2):e1.
[7] Pogrel MA.Coronectomy: Partial Odontectomy or Intentional Root Retention[J]. Oral Maxillofac Surg Clin North Am, 2015, 27(3):373-382.
[8] 王菲, 闫子玉, 许向亮, 等. 牙冠切除术结合支抗钉牵引分阶段拔除下颌阻生第三磨牙的临床研究[J]. 中华口腔医学杂志, 2024, 59(8):791-797.
[9] Peixoto AO, Bachesk AB, Leal MOCD, et al.Benefits of Coronectomy in Lower Third Molar Surgery: A Systematic Review and Meta-analysis[J]. J Oral Maxillofac Surg, 2024, 82(1):73-92.
[10] Kang F, Xue Z, Zhou X, et al. Coronectomy: A Useful Approach in Minimizing Nerve Injury Compared With Traditional Extraction of Deeply Impacted Mandibular Third Molars[J]. J Oral Maxillofac Surg, 2019, 77(11):2221.e1-2221.e14.
[11] Mann A, Scott JF.Coronectomy of mandibular third molars: a systematic literature review and case studies[J]. Aust Dent J, 2021, 66(2):136-149.
[12] Di Spirito F, Caggiano M, Acerra A, et al.Re-Intervention Rate, Timing, and Indications Following Coronectomy of the Mandibular Third Molar: A Systematic Review of Systematic Reviews[J]. J Clin Med, 2025, 14(11):3877.
[13] Kang FW, Yuan XR, Li GC, et al.Coronectomy in Lower Third Molar Surgery: A Systematic Review and Meta-Analysis[J]. J Oral Maxillofac Surg, 2025, 83(5):601-615.
[14] Póvoa RCS, Mourão CFAB, Geremias TC, et al.Does the Coronectomy a Feasible and Safe Procedure to Avoid the Inferior Alveolar Nerve Injury during Third Molars Extractions? A Systematic Review[J]. Healthcare (Basel), 2021, 9(6):750.
[15] Pitros P, O’Connor N, Tryfonos A, et al. A systematic review of the complications of high-risk third molar removal and coronectomy: development of a decision tree model and preliminary health economic analysis to assist in treatment planning[J]. Br J Oral Maxillofac Surg, 2020, 58(9):e16-e24.
[16] Barcellos BM, Velasques BD, Moura LB, et al.What Are the Parameters for Reoperation in Mandibular Third Molars Submitted to Coronectomy? A Systematic Review[J]. J Oral Maxillofac Surg, 2019, 77(6):1108-1115.
[17] van Bodegraven A, Simons RN, Tuk JG, et al. Coronectomy of mandibular third molars with dental pathology: a prospective cohort study of 121 molars[J]. Oral Maxillofac Surg, 2025, 29(1):44.
[18] Simons RN, Tuk JG, Ho JTF, et al.Early root migration after a mandibular third molar coronectomy[J]. Oral Maxillofac Surg, 2023, 27(2):353-364.
[19] Simons RN, Lindeboom JA, Tuk JG, et al.Postoperative Outcome After Coronectomy Versus Surgical Removal of Impacted Mandibular Third Molars-Clinical and Oral Health-Related Quality of Life Follow-Up[J]. J Oral Maxillofac Surg, 2024, 82(9):1109-1120.
[20] Mancini A, Inchingolo AM, Chirico F, et al.Piezosurgery in Third Molar Extractions: A Systematic Review[J]. J Pers Med, 2024, 14(12):1158.

Staged Crown-Root Segmentation Extraction of an Impacted Mandibular Third Molars Adjacent to the Inferior Alveolar Nerve: A Case Report

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