Coronectomy and Root Traction of Third Molars in Contact With the Inferior Alveolar Canal: Clinical Case Report

ABSTRACT Background Coronectomy consists of removing the crown of an impacted lower third molar (L3M) whose roots are in direct contact with the inferior alveolar canal (IAC), keeping the roots in place to avoid injuries to the inferior alveolar nerve (IAN) and changes in sensitivity. Clinical studies have shown that the technique is safe and presents low rate of postoperative complications; however, submerged root remnants require long‐term clinical and radiographic follow‐up, since after crown removal the roots can become more superficial, ankylosed, resorbed or may remain intact. AIM: this paper presents a case report of a technique employing coronectomy of third molars close to the IAC, followed by orthodontic traction of the root remnant up to a level to allow safe removal in a second surgical step. Case Report A male patient required extraction of tooth whose roots were in contact with the IAC. The first surgery comprised coronectomy and fixation of an orthodontic implant in the root canal of the unerupted tooth and another in the mandibular ramus. A NiCr spring was stretched connecting the two implants, generating a traction vector to distance the root apices from the IAC. Three months after the first surgery, another tomograph was requested, which evidenced complete distance between the root apex and the IAC. Therefore, a second procedure was performed to remove the roots and traction devices. Conclusion Coronectomy with orthodontic traction is a technique with potential utilisation for extraction of third molars contacting the IAC. Clinical studies should be conducted to evaluate the safety and predictability of this technique.