Coronectomy: why a wisdom tooth root may be left in place
Originally published
A coronectomy is an operation to remove the crown of a lower wisdom tooth while leaving its roots in the jaw. It may be offered when the roots lie close to the nerve that supplies feeling to the lower lip and chin. Leaving suitable roots in place can reduce the risk of damaging that nerve during removal.
It does not eliminate nerve injury or the other risks of surgery. Your surgeon should explain how it compares with removing the whole tooth or monitoring it.
When is it suitable?
Not every impacted wisdom tooth needs an operation. The dentist first considers whether there is a reason to treat it, then assesses the tooth, roots and their relationship to the nerve. X-rays are used for planning; additional imaging may be needed.
The retained roots need to be suitable to leave behind. Decay or infection affecting them can make coronectomy inappropriate. Diabetes, osteoporosis or a weakened immune system do not automatically make this the right alternative to extraction: your health and medicines need individual assessment.
What happens during the operation?
The surgeon removes the crown and leaves the roots below the gum. Anaesthetic and any sedation are planned around the procedure and your needs. If the roots become mobile during surgery, they may have to be removed, so the plan can change during the operation.
Possible complications include pain, swelling, bleeding, infection and altered sensation. Nerve injury can sometimes be lasting. The UCLH coronectomy leaflet explains the reasons for treatment and its limitations.
Recovery and retained roots
Follow the instructions provided by your surgical team about cleaning, eating, smoking and pain relief. Recovery and the time needed away from work vary. Tell the team about all medicines you take. Do not stop prescribed aspirin or another blood-thinning medicine yourself; any change needs advice from the clinicians responsible for your care.
Roots may move after a coronectomy. This does not mean that everyone needs a planned second operation a few months later. Some roots remain without causing problems; others may need removal if they become exposed, infected or troublesome. Attend the follow-up advised and contact the team about worsening pain, swelling, persistent bleeding or altered sensation.
Cost and deciding on treatment
The listed coronectomy fee is from £200. Ask what your estimate includes and whether imaging, sedation or other care carries a separate charge. See our oral surgery fees and current finance information.
A consultation is the place to discuss the likely benefits and risks for your tooth. Contact the practice if you have been advised that a wisdom tooth is close to a nerve.