Coronectomy: A Conservative Approach to Wisdom Tooth Removal
What Is a Coronectomy?
A Coronectomy is a specialized procedure designed as an alternative to full wisdom tooth extraction. Instead of removing the entire tooth, only the crown—the visible part above the gumline—is taken out, while the roots are intentionally left in place. This technique is most commonly recommended for lower wisdom teeth (mandibular third molars) when removing the roots could risk injury to important nerves in the jaw.
Why Is a Coronectomy Performed?
Wisdom teeth often become impacted, meaning they do not have enough room to emerge properly and can cause pain, infection, or crowding. Traditionally, these teeth are fully extracted. However, in some cases, the roots of the wisdom tooth are located very close to the inferior alveolar nerve—a nerve that supplies feeling to the lower lip, chin, and teeth. Removing the entire tooth in these situations can sometimes lead to nerve damage, resulting in numbness, tingling, or even permanent changes in sensation.
A Coronectomy is recommended when:
- The roots of the wisdom tooth are close to or touching the nerve.
- There is a high risk of nerve injury with standard extraction.
- The tooth and roots are healthy, without signs of infection or decay.
How is a Coronectomy Performed?
The procedure begins with a thorough assessment, during which your oral surgeon will use a 3D CBCT scan to evaluate the position of your wisdom tooth and its proximity to the nerve. To ensure your comfort throughout the procedure, local anesthesia is administered to numb the area. Once you are comfortable, a small incision is made in the gum to expose the tooth. The crown is then carefully separated from the roots using specialized instruments, while the roots are left undisturbed and smoothed down below the level of the surrounding bone. Finally, the gum is stitched closed over the roots, typically with dissolvable stitches.
The procedure generally takes about 20–40 minutes. Most patients recover within two weeks. Dissolving stitches will fall out on their own. It’s important to follow all post-operative care instructions to ensure proper healing.
