Three-dimensional radiographic evaluation of root migration patterns 4-8.5 years after lower third molar coronectomy: a cone beam computed tomography study

Int J Oral Maxillofac Surg. 2018 Sep;47(9):1145-1152. doi: 10.1016/j.ijom.2018.03.014. Epub 2018 Apr 5.

Abstract

This prospective study in patients with a follow-up of 4-8.5years aimed to describe the long-term, three-dimensional changes of coronectomized lower third molar roots. Pre- and postoperative cone beam computed tomography (CBCT) scans were compared. The distance of root migration, the direction of root translation and rotation, and the amount of bone regeneration at the adjacent second molar and superficially to the third molar root were recorded. Age, gender, time elapsed following surgery, the status of the retained root including, impaction pattern and depth of impaction were tested to check if they were influencing factors for the above outcomes. A total of 57 coronectomized third molars from 44 patients were included. The distance of the mean root migration was 2.82mm, and they predominantly translated mesially (76.8%). Age negatively correlated with the distance of migration. Root remnants with a soft tissue coverage had less bone regenerated at the adjacent second molar (1.27mm vs. 2.95mm) in comparison to their impacted counterparts. Based on the present radiographic results and the absence of any pathological findings, coronectomy can be recommended for selected cases of third molar removal as a safe procedure with favourable long-term outcomes.

Keywords: cone beam CT; coronectomy; root migration; third molar.

MeSH terms

  • Adult
  • Bone Regeneration
  • Cone-Beam Computed Tomography / methods*
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods*
  • Male
  • Molar, Third / diagnostic imaging*
  • Molar, Third / surgery*
  • Prospective Studies
  • Rotation
  • Tooth Crown / surgery*
  • Tooth Migration / diagnostic imaging*
  • Tooth Root / diagnostic imaging*
  • Tooth, Impacted / diagnostic imaging
  • Tooth, Impacted / surgery
  • Treatment Outcome