The Necessity of Root Canal Treatment Following Coronectomy in Mandibular Third Molars: A Randomized Controlled Trial

Objectives: In the following study, the focal area of discussion is to evaluate and record any infection or complication caused by the remanent root that was intentionally left inside to avoid injury to the inferior alveolar nerve (IAN). This research aimed to determine the effectiveness of the root canal treatment (RCT) with the coronectomy (CM) procedure and evaluate the importance of endodontic treatment during coronectomies. Materials and Methods: The study included 96 patients. The participants with proximity to IAN diagnosed based on radiographs and standard criteria were selected and divided into two equal groups of 48 each by lottery method into CM and CM with RCT following CM groups. Patients were re-evaluated for 3 weeks for complications and 3 months follow-ups for radiographic evaluations of root-fragment migration. Results: The overall average age of participants was 23.6 ± 2.7 years. The infection was found in 52 participants overall, with 12 occurring in the control and 40 in the experimental groups. Additionally, root-fragment migration was observed to be higher in the control group (2.2 ± 0.4 mm) compared to the experimental group (0.5 ± 0.2 mm), with an overall average of 1.3 ± 0.9 mm. The roots had also moved coronally at three months follow-up after the operation in the control group by a mean of 1.4 ± 0.9mm for the males and 1.3 ± 0.9mm for the females. Conclusion: The outcome of this research concludes that one may not need endodontic treatment following a CM procedure of an impacted mandibular third molar with close relations with IAN. Clinical application: If CM is chosen, it is better to leave the roots in place and allow them to migrate naturally rather than attempt to treat them with RCT.