METHODS: Retrospective analysis of 167 coronectomies completed between January 2017 to December 2022 was undertaken.
RESULTS: The success of coronectomy was 93%. Intra-operative failure was reported to be 3.6% (n = 8). Complications accounted for pain (15%, n = 24), infection (9%, n = 15) and dry socket (3.6%, n = 6). Three patients required removal of M3M root at 3 months (n = 2) and 24 months (n = 1), accounting for 1.8% re-operation rate. A total of number of patients who suffered a nerve injury was 12; three of these were permanent (LN - 1.2%, n = 2; IAN - 0.6%, n = 1), nine were temporary (IAN - 1.2%; n = 2, LN - 2.4%; n = 4; site not specified - 1.8%, n = 3). No patients with intra-operative failure and re-operation suffered IAN or LN injury post-operatively.
CONCLUSIONS: Coronectomy offers a successful strategy for management of high risk M3M. The treatment outcomes can be improved with careful case selection and adjusting surgical technique, including assessment of root morphology, incomplete crown sectioning technique and avoidance of lingual retraction. Reporting of coronectomy success as a factor of surgical outcome, presence or absence of permanent IAN injury, persistent symptoms or any other long-standing complications (such as LN injury), and the need for re-operation accounting for root migration status may be a useful tool to measure coronectomy outcomes.
方法:对2017年1月至2022年12月完成的167例冠状动脉切除术进行回顾性分析。
结果:冠状动脉切除术的成功率为93%。术中失败报告为3.6%(n=8)。并发症占疼痛(15%,n=24),感染(9%,n=15)和干插座(3.6%,n=6)。三名患者需要在3个月(n=2)和24个月(n=1)去除M3M根,占再手术率1.8%。遭受神经损伤的患者总数为12;其中三个是永久性的(LN-1.2%,n=2;IAN-0.6%,n=1),9个是临时的(IAN-1.2%;n=2,LN-2.4%;n=4;未指定地点-1.8%,n=3)。术中失败和再次手术的患者术后无IAN或LN损伤。
结论:冠状动脉切除术为高危M3M的管理提供了一个成功的策略。通过仔细选择病例和调整手术技术,可以改善治疗效果。包括根形态的评估,不完整的牙冠切开术和避免舌回缩。报告冠状动脉切除术的成功是手术结果的一个因素,是否存在永久性IAN损伤,持续性症状或任何其他长期并发症(如LN损伤),考虑根迁移状态的再手术需求可能是测量冠状动脉切除术结果的有用工具。