Comparison of Coronectomy and complete extraction for impacted Third Molars in Close Proximity to Inferior Alveolar Nerve

Abstract

Objective: To compare the effectiveness and safety of coronectomy versus complete extraction for the removal of impacted mandibular third molars in proximity to the inferior alveolar nerve. Study Design and Setting: This is a prospective, comparative interventional studythat was carried out at the Department of Oral and Maxillofacial Surgery at de’Montmorency College of Dentistry/Punjab Dental Hospital, Lahore. The study occurs within a time frame of six months and begins after the study proposal was approved by the College of Physicians and Surgeons Pakistan (CPSP) and the institutional ethics review board. Methodology: A total of 160 patients were recruited, with equal allocation into two groups: 80 participants in the coronectomy group and 80 in the complete extraction group. Data collection was done using a structured proforma, and statistical analysis was conducted using SPSS version 27. Independent sample t-tests were applied for comparing mean pain durations, while chi-square tests were used for assessing group differences in paresthesia and swelling. A p-value of = 0.05 was considered statistically significant throughout. Results: Coronectomy is associated with significantly better postoperative outcomes compared to complete extraction. While both groups were comparable in terms of age, gender, and tooth laterality, the coronectomy group experienced a significantly shorter duration of pain (p = 0.004) and markedly lower incidences of paresthesia (p = 0.0001) and swelling (p = 0.0001). Conclusion: Coronectomy is associated with fewer postoperative complications, particularly swelling and paresthesia, making it a safer alternative to total extraction in cases where the impacted third molar is close to the inferior alveolar nerve.