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Removal of unerupted teeth
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
Catherine Bryant, Clare Gleeson
The importance of identifying that an unerupted tooth is closely related to a sensory nerve which could be damaged during its extraction cannot be understated. A failure to appreciate this and the spacial relationship between tooth and nerve may result in a patient suffering an avoidable permanent post-operative sensory deficit, possibly accompanied by neuropathic pain, which can be functionally disabling in some individuals. Unerupted mandibular canine, premolar and molar teeth present the greatest risk of neuropathy within the distribution of the IAN but the removal of high, unerupted maxillary teeth and the injudicious use of flap retractors high in the buccal sulcus during extractions in the maxillary arch can also disrupt the infraorbital branch of the maxillary nerve. In cases where surgical intervention is unavoidable but CBCT scanning demonstrates an intimate relationship between the root of an unerupted tooth and the inferior dental canal (IDC) suggesting that the surgical removal of the entire tooth would present an increased risk of post-operative neuropathy, coronectomy may be considered. Coronectomy, or partial odontectomy is a conservative surgical technique in which the crown of a tooth is removed but its roots or (root) are deliberately left in situ. In carefully selected cases, this alternative to the complete removal of a tooth may represent the treatment of choice to reduce the risk of post-operative neuropathy (Figure 6.2).
Frequency and type of tooth extractions in adults vary by age: register-based nationwide observations in 2012–2017
Published in Acta Odontologica Scandinavica, 2023
Miira M. Vehkalahti, Irja Ventä, Maria Valaste
The register system of the SII places under the same main category all patients who received any oral surgical procedure. Thus, it was impossible to distinguish numbers of those patients who received just tooth extractions, while the data offered the information of the numbers of tooth extractions. In addition to tooth extractions and other tooth-based procedures, such as hemisection, apicoectomy and coronectomy, there are other types of oral surgical treatments; most of them infrequent, whereas e.g. the placement of a dental implant is frequent in the private dental care, where per year about 20,000 patients receive implants [21]. This indicates that patients with oral surgical procedures other than tooth extractions made up only a minor part of all patients receiving oral surgical procedures. Consequently, the rates of patients undergoing oral surgical treatments only slightly overestimate the actual rates of patients receiving tooth extractions.