Dr.Omesh Modgill
specialty doctor in the oral surgery department of Kings College Hospital ,London
Title: Title: The use of coronectomy in the management of mandibular teeth in paediatric patients
Biography
Biography: Dr.Omesh Modgill
Abstract
IntroductionrnOccasionally paediatric patients present with symptomatic, unerupted non-third molar mandibular teeth which require surgical intervention but are known to be closely related to adjacent sensory nerves. rnrnCoronectomy is a conservative surgical technique in which the crown of a tooth is removed whilst the roots are deliberately left in situ and may represent the treatment of choice in this situation. Coronectomy is widely and successfully used to reduce the risk of postoperative neuropathy in the surgical management of symptomatic mandibular third molars which are intimately related to the inferior alveolar nerve canal. rnrnMaterials and MethodsrnWe present three paediatric patients who had coronectomy as part of a paediatric dental, orthodontic and oral surgery multidisciplinary treatment plan. They were all assessed clinically, radiographically and with the use of cone beam tomography prior to treatment under day case general anaesthetic. rnrnResultsrnNo patient experienced temporary or permanent postoperative sensory neuropathy or required further surgical intervention for root retrieval following coronectomy.rnrnAn excellent result was achieved for the patient who had orthodontic treatment after coronectomy; the deliberately retained roots had little adverse effect on the alignment of adjacent teeth.rnrnDiscussionrnWe have demonstrated that coronectomy can be used successfully in paediatric patients as an alternative to extraction in the management of mandibular teeth in cases where extraction is considered to present a ‘high risk’ of postsurgical neuropathy. Whilst coronectomy may reduce the risk of neuropathy compared to extraction, it is not a risk or complication- free procedure.rn