What are the parameters for reoperation in mandibular third molars submitted to coronectomy? A systematic review

Publication date: Available online 23 January 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Bhárbara Marinho Barcellos, Bibiana Dalsasso Velasques, Lucas Borin Moura, Cristina Braga Xavier

Purpose

Coronectomy is an alternative technique to conventional lower third molar removal which aims to reduce inferior alveolar nerve impairment. The study's purpose is to identify factors associated with reoperation after mandibular third molar coronectomy.

Material and Methods

This systematic review sought for scientific articles in PubMed/MEDLINE, Elsevier/Scopus, and Cochrane Library databases. Studies that evaluated reoperation from coronectomy and a minimum follow-up of six months were included. The PRISMA quality assessment of the included articles was performed, and the following data were analyzed: demographic characteristics, reason for reoperation and time between coronectomy and reoperation. The data was submitted to descriptive analysis.

Results

The initial search found 362 studies and 15 were included in the final review. In total, 1664 patients and 2062 teeth were submitted to coronectomy. Most of them were female (60.58%). The follow-up period for reoperation ranged from 6 months to 10 years and mean until the second procedure time was 10.4 months (Q₁=3; Q₃=8.5). Only 105 (5.1%) teeth were reoperated. The main reasons for reoperation were root exposure (53.33%), infection (10.47%), pain (9.52%) and enamel residual (9.52%). Regarding to PRISMA quality evaluation, only one article presented low risk of bias.

Conclusion

Reoperation after mandibular third molar coronectomy is low, around 5% of the cases; the main reasons were residual root exposure and symptomatology. Due the possibility of late exposure or symptomatology, we recommend a follow-up longer than six months until the root exposure or the end of migration process.

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