Reviewed By Dr. Robert Barron, DMD
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If the roots of a lower wisdom tooth are very close to a nerve in the jaw, removing the entire tooth may carry a greater risk of nerve injury. In some cases, an oral surgeon may recommend removing only the crown of the tooth and intentionally leaving the roots in place. This procedure is called a coronectomy.
Table of Contents
What Is a Coronectomy?
A coronectomy is an alternative to complete wisdom tooth removal that may be considered when the roots of a lower wisdom tooth are positioned very close to the inferior alveolar nerve.
Instead of removing the entire tooth, only the crown of the tooth is removed and the roots are left undisturbed in the jaw. The goal is to treat the problematic portion of the wisdom tooth while reducing surgical manipulation around the nearby nerve.
When a Coronectomy May Be Recommended
The inferior alveolar nerve runs through the lower jaw and provides sensation to the lower teeth, lower lip, chin, and surrounding tissues. In some people, the roots of a lower wisdom tooth develop very close to this nerve.
When a wisdom tooth needs to be removed, its relationship to the nerve is an important part of surgical planning. Attempting to remove roots that are very close to the nerve can increase the risk of temporary or, less commonly, permanent changes in sensation.
A coronectomy may be considered when imaging shows that leaving the roots in place could reduce this risk. The roots must also be healthy and stable enough to remain in the jaw. If they are infected, mobile, or affected by disease, a coronectomy may not be appropriate.
How a Coronectomy Is Performed
Before surgery, Dr. Barron reviews CBCT imaging to evaluate the position of the wisdom tooth roots and their relationship to the inferior alveolar nerve.
During the procedure, the crown of the wisdom tooth is separated from the roots and removed. The retained roots are reduced below the level of the surrounding bone so the area can heal over them. The roots are intentionally kept stable and are not removed unless necessary.
The surgical site is then cleaned and closed. Local anesthesia is used during treatment, and sedation may also be available depending on the procedure and the patient’s needs.
What Happens to the Retained Roots?
One of the most common concerns about a coronectomy is what happens to the portion of the wisdom tooth that remains in the jaw.
In many cases, the retained roots stay beneath the bone and gum tissue without causing problems. Because they are intentionally left in place, their presence alone does not mean another procedure will be necessary.
The roots can also gradually migrate after surgery. When this occurs, they typically move away from the inferior alveolar nerve. This movement can happen as the surrounding bone heals and does not necessarily indicate a complication.
If a retained root later becomes exposed, painful, infected, or otherwise causes a problem, Dr. Barron can evaluate whether it needs to be removed. If the root has moved farther away from the nerve by that point, removal may carry less nerve risk than it would have during the original surgery.
Recovery After a Coronectomy
Recovery from a coronectomy is generally similar to recovery after lower wisdom tooth removal. Swelling, soreness, minor bleeding, and temporary jaw stiffness are common during the first few days.
Following your post-operative instructions is important while the surgical site heals. You will be advised to eat soft foods, keep the mouth clean, and avoid activities that could disturb the surgical site.
Specialized Training for Complex Wisdom Teeth
When wisdom tooth roots are positioned close to the inferior alveolar nerve, treatment requires careful surgical planning and an understanding of the anatomy of the jaw. Oral and maxillofacial surgeons receive advanced surgical training in the diagnosis and treatment of conditions affecting the teeth, jaws, and surrounding structures.
Dr. Robert Barron brings this specialized training and extensive surgical experience to complex wisdom tooth cases. When a coronectomy is being considered, he evaluates whether leaving the roots in place offers an appropriate alternative to complete extraction and discusses the benefits, limitations, and follow-up involved before surgery.
Discuss Your Wisdom Tooth Treatment Options
If you have been told that a lower wisdom tooth is close to a nerve, a coronectomy may be one option for reducing nerve risk while treating the tooth. Dr. Barron can review your individual anatomy and explain whether complete wisdom tooth removal or a coronectomy is appropriate for you.
To schedule an appointment at our oral surgery office in Vaughan, call (905) 669-2616 or visit us at 3300 Hwy 7 W #805, Vaughan, ON L4K 4M3.
FAQs
Is a coronectomy safer than removing the whole wisdom tooth?
When the roots of a lower wisdom tooth are very close to the inferior alveolar nerve, a coronectomy can reduce the risk of nerve injury compared with removing the entire tooth. Because the roots are left in place, there is less manipulation around the nerve during surgery.
Can wisdom tooth roots cause problems after a coronectomy?
Most retained roots do not require further treatment. Occasionally, a root may migrate, become exposed, develop an infection, or cause symptoms that require evaluation.
Will the roots need to be removed later?
Not usually. Removal may be recommended if the retained roots become exposed, infected, painful, or otherwise problematic.
Do the roots continue to grow after a coronectomy?
No. The retained roots do not continue growing into a new tooth. They can migrate within the jaw during healing, usually moving away from the inferior alveolar nerve.
