Standardized coronectomy versus total extraction for impacted mandibular third molars: a single-blinded prospective analysis of patient-reported outcomes

Introduction Coronectomy is proposed as an alternative to surgical extraction for impacted mandibular third molars, particularly in cases with an elevated surgical risk of inferior alveolar nerve injury. However, this procedure is not widely adopted by many surgeons due to concerns about potential complications and the perception that patients may be less likely to accept this treatment option. Methods This cross-sectional, prospective, single-blinded study compared patient-reported outcomes between standardized coronectomy and extraction of impacted mandibular third molars in 70 patients (aged 19–55 years) using the Postoperative Symptom Severity (PoSSe) scale. Results While coronectomy avoided nerve injury, it resulted in relatively longer recovery times (40% vs. 28.6% requiring ≥5 days) and prolonged medication use (34.3% vs. 14.3% >5 days) compared to extraction. Coronectomy patients reported significantly higher pain and swelling scores, particularly among females (>25 years), though neither procedure adversely affected eating, speech, or quality of life. Gender and age influenced outcomes, with females and older patients experiencing more pronounced postoperative morbidity after coronectomy. Discussion These findings underscore the need for demographic-specific counseling and tailored postoperative care when selecting coronectomy. Further research with larger sample sizes is recommended to validate these findings and optimize decision-making for mandibular third molar surgeries.

• Publication year

  2025

• Venue

  Frontiers in Oral Health

• Publication date

  2025-08-05

• Fields of study

  Medicine

• Identifiers
  DOI 10.3389/froh.2025.1647852PMID 40837146PMCID 12361201
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Establishing universal sectioning depth and angle for surgical coronectomy of impacted mandibular third molars: an imaging-based study

  2024cited by this paper
• Evaluation of the Efficacy of Oral and Intramuscular Administration of Dexamethasone on Postoperative Pain, Swelling, and Trismus After Surgical Removal of Impacted Third Molar: A Comparative Split-Mouth Study

  2023cited by this paper
• Patient's perception of recovery following surgical removal of mandibular third molars. A prospective european multi-center study.

  2023cited by this paper
• Misleading information before lower third molar surgery - 40 years of failing our patients?

  2022cited by this paper
• Postoperative online follow-up improves the quality of life of patients who undergo extraction of impacted madibular third molars: a randomized controlled trial

  2020cited by this paper
• Effect of lingual-based flap design on postoperative pain of impacted mandibular third molar surgery: Split-mouth randomized clinical trial

  2020cited by this paper
• Effect of submucosal dexamethasone injections in the prevention of postoperative pain, trismus, and oedema associated with mandibular third molar surgery: a systematic review and meta-analysis.

  2019cited by this paper
• Comparative assessment of dexamethasone administration routes for the management of postoperative symptoms following third molar surgery.

  2019cited by this paper
• How Patients Percept Their Recovery Following Impacted Mandibular Third Molar Coronectomy

  2016cited by this paper
• Coronectomy versus surgical removal of the lower third molars with a high risk of injury to the inferior alveolar nerve. A bibliographical review

  2015cited by this paper
• Recovery after third-molar surgery: the effects of age and sex.

  2010cited by this paper
• Impacted mandibular third molars among patients attending Hospital Universiti Sains Malaysia

  2009cited by this paper
• Safety of coronectomy versus excision of wisdom teeth: a randomized controlled trial.

  2009cited by this paper
• Sensory testing of inferior alveolar nerve injuries: a review of methods used in prospective studies.

  2009influential reference
• Evaluation of the indication for surgical extraction of third molars according to the oral surgeon and the primary care dentist. Experience in the Master of Oral Surgery and Implantology at Barcelona University Dental School

  2008cited by this paper
• The incidence of mandibular third molar impactions in different skeletal face types.

  2008cited by this paper
• Evaluation of the indication for surgical extraction of third molars according to the oral surgeon and the primary care dentist. Experience in the Master of Oral Surgery and Implantology at Barcelona University Dental School.

  2008cited by this paper
• Assessing postoperative discomfort after third molar surgery: a prospective study.

  2007cited by this paper
• The complex role of estrogens in inflammation.

  2007cited by this paper
• A randomised controlled clinical trial to compare the incidence of injury to the inferior alveolar nerve as a result of coronectomy and removal of mandibular third molars.

  2005cited by this paper
• Coronectomy: a technique to protect the inferior alveolar nerve.

  2004cited by this paper
• Pattern of third molar impaction in a Singapore Chinese population: a retrospective radiographic survey.

  2003cited by this paper
• Recovery after third molar surgery: clinical and health-related quality of life outcomes.

  2003cited by this paper
• Gadolinium an alternative contrast agent for sialography in patients with iodine sensitivity.

  2003cited by this paper
• The surgical removal of mandibular third molars: a study in decision making.

  2002cited by this paper
• Indications for the extraction of impacted third molars in a semi-urban Nigerian Teaching Hospital.

  2001cited by this paper
• Assessing health outcomes after extraction of third molars: the postoperative symptom severity (PoSSe) scale.

  2000cited by this paper
• The radiological prediction of inferior alveolar nerve injury during third molar surgery.

  1990cited by this paper
• [Surgical deductions].

  1984cited by this paper
• The incidence of impacted teeth. A survey at Harlem hospital.

  1970cited by this paper

• No citing papers are available for this paper.