Sir, the coronectomy procedure has become widely used in the treatment of vital teeth which are deemed at 'high risk 'of causing inferior alveolar nerve injury (IANI).
Once the root of the tooth is deemed to be involved with the inferior alveolar nerve (IAN) canal radiographically, there is a 20% risk of the patient developing temporary IANI and a 1-4% risk of developing permanent IANI with surgical removal.1
With the push by managing bodies to find cost effective alternatives to providing high quality care, there have been oral surgery contracts commissioned to provide services in primary care settings, which are usually delivered by secondary care providers, through specialist dentists or dentists with specialist interests.
Although the duty of gaining consent from the patient lies mainly with the operating surgeon, there is an onus on the referring practitioner to be able to provide the various treatment options to allow the patient to make an informed decision and prevent inappropriate referrals.
Although indicated in the National Institute for Health and Care Excellence (NICE) as an alternate treatment for third molar extractions, coronectomy is often overlooked by the general dental practitioner (GDP).
With the rise in third molar surgery being carried out in a primary care setting, it is important for the GDP to be competent in giving the patient all treatment options to allow an informed decision to be made.
References
Renton T, Hankins M, Sproate C, McGurk M. A randomised controlled clinical trial to compare the incidence of injury to the inferior alveolar nerve as a result of coronectomy and removal of mandibular third molars. Br J Oral Maxillofac Surg 2005; 43: 7-12.
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Shaath, M. Coronectomy consent. Br Dent J 226, 470–471 (2019). https://doi.org/10.1038/s41415-019-0218-6
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DOI: https://doi.org/10.1038/s41415-019-0218-6
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