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This study aimed to analyze post-coronectomy complications, chronological root survival rate (success rate) using Kaplan-Meier analysis, and postoperative radiographic signs for root extraction. A total of 555 mandibular third molar coronectomies were clinically and radiologically evaluated (mean follow-up period, 27.2 months; range, 1 month to 10.5 years). Complications were observed in 22 (4.0%) cases. Temporary inferior alveolar nerve damage was observed in one (0.2%) case, and 21 (3.8%) retained roots required extraction between 1 and 64 months after coronectomy due to dry socket (two cases, 0.4%), primary non-wound closure (10 cases, 1.8%), secondary root exposure (seven cases, 1.3%), and submucosal root eruption (two cases, 0.4%). Residual enamel after coronectomy was more significantly found on 13 (61.9%) of 21 extracted roots than on 30 (5.6%) of 534 surviving roots. Kaplan-Meier analysis revealed an overall survival rate of 93.8% at 5 years and 92.2% at 10 years. The 5-year survival rates differed significantly (p < 0.001) between the enamel-free (97.0%) and residual enamel-attached (58.3%) roots. The Cox proportional hazards model showed a hazard ratio of 20.87 (95% confidence interval, 8.58-50.72). The long-term outcomes of coronectomy were satisfactory, and a higher success rate is expected when the enamel is completely removed during coronectomy., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Coronectomy is an alternative procedure for removing mandibular third molars near the inferior alveolar nerve. Limited research exists on the effect of coronectomy on the postoperative quality of life (QoL)., Purpose: This study compared postoperative QoL after coronectomy and complete surgical removal of mandibular third molars during the first postoperative week., Study Design, Setting, and Sample: This prospective cross-over study was conducted in the Oral and Maxillofacial Department of Amstelland Hospital, Amstelveen, The Netherlands. The study sample consisted of patients with indications for removal of both mandibular third molars, with one at increased risk of nerve injury undergoing coronectomy, while the other molar was extracted. Exclusion criteria were ibuprofen allergy, anticoagulant therapy, systemic disease, local pathology, or failure to complete the Oral Health Impact Profile-14 (OHIP-14) questionnaire., Independent Variable: The independent variable was the surgical procedure, categorized as coronectomy or complete mandibular third molar removal. An 8-week period was maintained between procedures., Main Outcome Variable: The primary outcome measure was the mean OHIP-14 score during the first postoperative week. Secondary outcome measures were pain, self-perceived discomfort, and self-care behaviors., Covariates: Sex, age, impaction patterns, and treatment order were analyzed as covariates., Analyses: Nonparametric tests, including the Friedman test for within-patient differences and the Wilcoxon signed-rank test for repeated measures, were used for non-normally distributed data. Significance was set at 5%, with P value adjustments per Bonferroni correction., Results: The sample included 55 patients (18 male and 37 female) with a mean age of 24.6 ± 4.7 years. Mean OHIP-14 scores during the first 6 postoperative days were significantly higher after coronectomy compared to after surgical removal (day 1: 24.93 ± 9.82 vs 22.7 ± 9.5; day 6: 11.27 ± 10.36 vs 8.49 ± 10.93) (P < .05). Pain was significantly higher on the second to sixth postoperative days after coronectomy (day 2: 6.02 ± 1.92 vs 5.78 ± 1.73; day 6: 4.11 ± 2.49 vs 3.09 ± 2.41) (P < .05). Patients used more analgesics after coronectomy (day 2: 4.09 ± 2.53 vs 3.27 ± 1.9; day 6: 2.76 ± 2.62 vs 2.13 ± 2.49) (P < .05). We found no differences in outcomes for sex or molar impaction (P > .05)., Conclusion and Relevance: Coronectomy significantly impacted postoperative oral health-related QoL compared to complete surgical removal of mandibular third molars., (Copyright © 2024 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Purpose: The purpose of this study was to assess success rates and to report complications of coronectomy of mandibular third molars (M3M), including intra-operative failure, pain, infection, dry socket, inferior dental alveolar (IAN) and lingual nerve (LN) injuries and re-operation rates., 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., Conclusion: 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., (© 2024. The Author(s).)

Objective: To investigate the impact of mineralized dentin matrix (MDM) on the prognosis on bone regeneration and migration of retained roots after coronectomy., Materials and Methods: Patients were divided into three groups based on the type of bone graft after coronectomy: Group C (n = 20, collagen), Group T (n = 20, tricalcium phosphate (TCP) + collagen), and Group D (n = 20, MDM + collagen). CBCT scans, conducted immediately and 6 months after surgery, were analyzed using digital software. Primary outcomes, including changes in bone defect depth and retained root migration distance, were evaluated 6 months after surgery., Results: After 6 months, both Groups D and T exhibited greater reduction of the bone defect and lesser retained root migration than Group C (p < 0.001). Group D had greater regenerated bone volume in the distal 2 mm (73 mm 3 vs. 57 mm 3 , p = 0.011) and lesser root migration (2.18 mm vs. 2.96 mm, p < 0.001) than Group T. The proportion of completely bone embedded retained roots was also greater in Group D than in Group C (70.0% vs. 42.1%, p = 0.003)., Conclusions: MDM is an appropriate graft material for improving bone defect healing and reducing retained root migration after coronectomy., Clinical Relevance: MDM is an autogenous material prepared chairside, which can significantly improve bone healing and reduce the risk of retained root re-eruption. MDM holds promise as a routine bone substitute material after M3M coronectomy., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Aim: This case series was to describe the use of surgical extrusion for three different cases as a technique to re-establish the biological width in patients with insufficient crown height., Background: Surgical extrusion serves as an important means to reestablishing a proper biological width. Such method provides an excellent alternative for the restoration of teeth with insufficient ferrule and ensuring a suitable dental restoration., Cases Descriptions: This case series describes the management of three different cases with compromised teeth #25, #35, and #44, respectively. The approach involved the surgical extrusion of the compromised sites from subgingival to supragingival and the splinting of the teeth using a semi-rigid splint. A successful prognosis was observed on follow-up visits., Conclusion: This technique is a good alternative for general practitioners because of its easy implementation and time efficiency. In addition, the method requires less equipment and provides for adequate space for the re-establishment of biological width., Clinical Significance: Such technique can re-establish a healthy biological width, the existing occlusion can be maintained without alterations, and it demonstrated the suitability of surgical extrusion technique in such clinical situations. Case selection is equally important. Cases with single-rooted teeth with fractures or caries in proximity to the marginal bone level without vertical root fractures generally provide positive outcomes on providing this treatment. How to cite this article: Boreak N, Al Moaleem MM, Zain AA, et al. Surgical Extrusion of Three Premolars to Re-establish the Biological Width: Case Series. J Contemp Dent Pract 2024;25(6):593-598.

Purpose: The purpose of this study was to determine how the surgeon's decision to perform a mandibular third molar coronectomy or surgical removal is associated with the impaction pattern as classified using Pell and Gregory or Winter's system., Methods: This observational, cross-sectional study was conducted on 813 mandibular third molars belonging to 565 patients. All patients were referred for removal of the mandibular third molar and had radiographic signs indicating a close relationship with the inferior alveolar nerve. Panoramic images were classified according to the impaction pattern., Results: A coronectomy was performed on 492 (60.5%) mandibular third molars. Most impacted mandibular third molars were class IIB with a mesioangular inclination. A significant association was found between the Pell and Gregory classification and the surgeon's choice (p = 0.002). Winter's classification was not significantly associated with surgeon choice (p = 0.425)., Conclusion: Mandibular third molar coronectomy is chosen more frequently than surgical removal if molars are class III and position B., Trial Registration Number: Not applicable., (© 2024. The Author(s).)

Objective: The aim of this research was to evaluate the surgical complications and neurosensory deficits after coronectomy and the complete removal of mandibular third molars., Methods: The study sample included patients requiring surgical removal of mandibular third molars. A coronectomy was conducted on 220 teeth showing signs of close proximity to the inferior alveolar canal. A complete extraction was performed on 218 teeth with no risk signs. The patients were evaluated at 1 week and 1, 3, 6, 12, and 24 months after surgery for pain, swelling, neurologic deficit, dry socket, postoperative bleeding, infection, root migration, and eruption., Results: No significant difference was noted in pain and swelling; however, bleeding and dry socket were significantly higher in the odontectomy group (P = .017). The inferior alveolar nerve deficit was higher in the odontectomy group (3.7%) than the coronectomy group (0.5%) (P = .017). The percentage and distance of root migration of coronectomised teeth at 3, 6, and 12 months were 60% (2.37 ± 0.96 mm), 66% (3.35 ± 0.86 mm), and 74% (3.85 ± 0.93 mm), respectively., Conclusions: Coronectomy is a safe procedure and should be performed when the roots are closely associated with the mandibular canal. Although root migration is common, the likelihood of root exposure is low and roots rarely need removal., Competing Interests: Conflict of interest None disclosed., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

This retrospective study evaluated the clinical outcomes of surgical crown reattachment in the treatment of complicated crown-root fractures in permanent teeth in 35 patients. Treatments were defined as follows: surgical crown reattachment combined with internal fixation with a fiberreinforced core post, ostectomy, and reattachment of the original crown fragment. Patients were examined to record the periodontal pocket depth (PD), marginal bone loss, tooth migration, and coronal fragment looseness or loss. In most cases, the fracture lines on the palatal aspect were located below the alveolar crest. About 20% to 30% of teeth had periodontal pockets ≥ 3 mm present at least 1 year after surgery. Significant PD differences were observed between the traumatized teeth and adjacent untraumatized teeth at 6 months. The available evidence suggests that surgical crown reattachment is a feasible and effective technique for managing complicated crown-root fractures in permanent teeth.

Searching for third molars atraumatic removal method remains a challenge in oral surgery. Method of partial removal of impacted tooth leaving a non-extracted root in the wound becomes more popular recently. Determining medical indications for this method, as well as searching for standards for its implementation is important. The paper presents a review on latest technique of performing a coronectomy, and the long-term results of this method. However, the technique of incomplete tooth extraction is highly controversial in terms of harm to the patient's health. There are also uncertain medical indications for this method and the legal treatment consequences.

Purpose: The purpose of this study was to measure and compare coronectomy versus extraction in patients at increased risk for inferior alveolar nerve (IAN) injuries associated with third molar removal in terms of IAN injury and other complications., Methods: The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist. We conducted a comprehensive literature search across six databases and the gray literature from July 15 to August 01, 2022. We employed Rayyan software to identify and remove duplicate articles to ensure data integrity. Our research followed the strategy patient (P), intervention (I), comparison (C), outcome (O), and study (S): (P) patients needing lower third molar surgery at higher risk of IAN injury; (I) surgery options, coronectomy or complete extraction; (C) comparisons included reduced risks of nerve injuries, postoperative complications (pain, infection, alveolitis), and increased risks of reoperation, root migration, and extraction; (O) desired outcomes were preventing nerve injuries and reducing other surgical complications; and (S) observational study designs (cohort, case-control). Excluded from consideration were studies involving teeth other than lower third molars, as well as reviews, letters, conference summaries, and personal opinions. To gauge the certainty of evidence, we employed the Grading of Recommendation, Assessment, Development, and Evaluation instrument, selecting the most current papers with the highest levels of evidence for inclusion. The primary outcome variable of our study centered on evaluating the incidence of IAN injury, and secondly, the lingual nerve (LN) injury, the postoperative pain, infection, localized alveolitis, the necessity for surgical reintervention, root migration, and extraction. These assessments were carried out with respect to their chosen operative technique for managing third molars, either coronectomy or extraction, as predictor variables. We also considered covariates such as age, gender, and the presence of systemic diseases in our analysis to account for potential confounding factors. The pooled data underwent rigorous analysis utilizing an inverse variance method with both random and fixed effect models by the "metabin" function in the R program's meta-package. Additionally, we assessed the risk of bias in the selected studies by utilizing the Joanna Briggs Institute's Critical Appraisal Checklist for Studies Reporting Prevalence Data and the Critical Appraisal Checklist for Case Reports., Results: Of the 1,017 articles found, after applying the inclusion and exclusion criteria, 42 were included in this study (29 cohort and 13 case-control studies), including 3,095 patients from 18 countries. The meta-analysis showed that coronectomy reduced the risk of IAN injury [OR (Odds Ratio): 0.14; 95% CI (confidence intervals): 0.06-0.30; I 2 (inconsistency index) = 0%; P = .0001], postoperative pain (OR: 0.97; 95% CI: 0.33-2.86; I 2  = 81%; P = .01), and alveolitis (OR: 0.38; 95% CI: 0.13-1.09; I 2  = 32.2%; P = .01) when compared to complete tooth extraction. However, it also highlighted a greater risk of reintervention (OR: 5.38; 95% CI: 1.14-25.28; I 2  = 0.0%; P = .01)., Conclusions: This study has demonstrated that coronectomy is associated with a decreased risk for IAN injury and decreased pain and localized alveolitis when compared to complete tooth extraction. However, it is essential to acknowledge the higher likelihood of requiring reintervention with coronectomy. Therefore, clinicians should carefully consider the advantages and potential drawbacks of both techniques and tailor their choices to the unique clinical circumstances of each patient., (Copyright © 2023 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Objectives: The aim of this in vitro study was to evaluate the effect of a 3D-printed drill sleeve (DS) on the precision and duration of coronectomy sections., Materials and Methods: Thirty-six trainees and oral surgeons performed 72 coronectomy cuts in a 3D-printed, entirely symmetric mandible model. Coronectomy was performed freehand (FH) on one side and with a DS on the other side. The occurrence of "too superficial" (≥ 4 mm unprepared lingual tooth tissue) and "too deep" (drilling ≥ 1 mm deeper as tooth contour) cuts and sectioning times were registered., Results: In 7 cases, the sections were "too deep" with FH, while none with DS (OR: 18.56; 95%CI: 1.02-338.5; p = 0.048). The deviation between virtually planned and real cut depths was significantly greater in the FH group (1.91 ± 1.62 mm) than in DS group (1.21 ± 0.72 mm) (p < 0.001). A total of 18 "too superficial" buccolingual sections occurred with FH, while 8 cases with DS (OR: 3.50; 95%CI: 1.26-9.72; p = 0.016). Suboptimal sections did not correlate with experience (p = 0.983; p = 0.697). Shortest, suboptimal drillings were most frequently seen distolingually (OR: 6.76; 95% CI: 1.57-29.07; p = 0.01). In the inexperienced group, sectioning time was significantly longer with FH (158.95 ± 125.61 s vs. 106.92 ± 100.79 s; p = 0.038)., Conclusions: The DS effectively reduced tooth sectioning times by less experienced colleagues. Independently from the level of experience, the use of DS obviated the need for any preparation outside the lingual tooth contour and significantly decreased the occurrence of "too superficial" cuts, leaving thinner unprepared residual tooth tissue lingually., Clinical Relevance: Coronectomy sections may result in lingual hard and soft tissue injury with the possibility of damaging the lingual nerve. The precision of the buccolingual depth-control can be improved, while surgical time can be reduced when applying a drilling sleeve., (© 2023. The Author(s).)

Purpose: Coronectomy is an operation to manage impacted third molars (M3s) considered at high risk for mandibular nerve injury but long-term outcomes are still lacking. The purpose of this study was to estimate the risk of late complications occurring within 10 years following lower M3 coronectomy., Methods: The investigators designed a prospective cohort study and enrolled a sample of 94 patients treated with coronectomy of third mandibular molars at the Unit of Oral and Maxillofacial Surgery of the University of Bologna, from 2009 to 2012. This follow-up study included all of the patients from the original study who completed 10 years of follow-up. The primary outcome variables is postoperative late complication occurring between 5 and 10 years after coronectomy coded as present or absent. Late complications were defined as root exposure, nerve injury, pulpitis, periapical infection, and reoperation. The secondary outcome variable was probing pocket depth. Covariates examined were age, smoking and type of M3 impaction. Descriptive statistical analyses were performed., Results: The inception cohort was composed of 94 subjects who had 116 coronectomies (k) completed. The study cohort was composed of subjects with 10 years of follow-up and included 48 subjects (k = 60) with a mean age of 28.99 ± 8.9 years. Between years 5 and 10 of follow-up, 2 subjects (4%) have complications; all root exposures diagnosed at years 8 or 9 after surgery. In another case root removal was required for orthodontics reason. No case of nerve injury to the inferior alveolar nerve occurred, and no periapical infection was observed around the residual roots. The mean 10-year probing pocket depth was 3.31 ± 0.92 mm (1,66-5,66 mm). There were too few complications to identify risk factors for late complications., Conclusions: Within all the limitations of this study, the results of this prospective study imply that coronectomy is a useful surgical technique for the treatment of M3s at high neurological risk, to avoid nerve injury to the inferior alveolar nerve. In addition, after coronectomy, retained roots did not develop late infection or periapical infection in the long term. However, in a few cases, removal of retained roots was required at 10 years, due to root migration in the oral cavity. The risk for late complications is uncommon, but persistent., (Copyright © 2023 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

The presence of subgingival pathology, such as a deep secondary caries lesion, a fracture, an already existing restoration that needs to be replaced or the presence of a resorption defect, can constitute a difficult starting situation for the preservation of a tooth. How to deal with such a situation has been a topic of discussion for years. Surgical crown lengthening is one of the first and classic treatment options that is often chosen in such cases. Crown lengthening is a periodontal surgical technique to obtain extra supra crestal clinical crown length. The question is, what is the long-term prognosis of teeth after surgical crown lengthening. To answer this question, a review of the literature was carried out looking for clinical studies examining survival. Four studies with a follow-up of at least 5 years were included. The factors that adversely affect survival of the tooth after the crown lengthening are an unfavourable crown-root ratio, insufficient plaque control and moderate ability to keep the restoration clean.

The dental pulp may respond favourably or unfavourably to traumatic dental injuries. The most serious unfavourable responses are pulp necrosis and infection of the root canal system. These cause apical periodontitis and/or external inflammatory resorption of the tooth. The following injuries require root canal treatment as part of their emergency management-(A) complicated crown fractures (but some may be suitable for conservative pulp treatments, such as pulp capping, partial pulpotomy or pulpotomy), (B) complicated crown-root fractures, (C) supra-crestal coronal third root fractures and (D) injuries where pulp necrosis is predictable or highly likely to occur AND where there has been damage to the root surface and/or periodontal ligament with the aim of preventing external inflammatory resorption. This latter group of injuries are avulsion, intrusion, lateral luxation with a crown fracture, extrusion with a crown fracture (all in fully developed teeth) plus avulsion with a crown fracture and intrusion with a crown fracture (both in incompletely developed teeth). All other injuries should not have root canal treatment commenced as part of the emergency management, but they must be reviewed regularly to monitor the pulp for any adverse changes to its status, particularly pulp necrosis and infection of the root canal system., (© 2023 The Authors. Australian Dental Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Dental Association.)

The aim of this study was to compare root trunk measurements taken parallel to the tooth axis (TA) to those taken parallel to the root surface (RS) in order to assess the decision-making implications of each method on crown-lengthening surgery. A total of 672 root trunks were measured via CBCT in two planes: TA and RS. The possibility of performing crown lengthening in each clinical situation based on the distance from the cementoenamel junction (CEJ) to the crestal bone (CB) after ostectomy (CEJ-CB) was judged and compared between groups. When RS was used as a reference point, the proportions of cases that judged crown lengthening to be possible were 83.63%, 59.08%, and 39.18% for CEJ-CB values of 4, 5, and 6 mm, respectively. When TA was used instead, those proportions decreased by 3.87% to 7.29%. The lingual root trunk of the lower first molar (LFL) with a CEJ-CB of 4 to 5 mm emerged as the most problematic area; here, the difference between reference planes occurred with one out of every six teeth. Within the limits of this study, utilizing TA for surgical crown-lengthening treatment planning is not ideal because it may lead to extraction of many savable teeth.

Intentional replantation involves a combination of periodontics, endodontics, prosthodontics and oral surgery. Crown-root fracture management is still complicated nowadays. A fracture line extending longitudinally to the subgingival area and intruding bioogical width could affect infection control, gingival health and crown restoration. In the present study, we present two cases. Case 1 involved a 23-year-old man who presented at our hospital with crown-root fracture of the maxillary left central incisor. A radiographic image of the tooth revealed a fracture line under the alveolar crest. The fractured tooth was treated with intentional replantation with 180-degree rotation, root canal treatment and veneer restoration. The patient was followed up for 60 months. The replanted tooth functioned well, and no symptoms of resorption or ankylosis were observed by radiographic examination. Case 2 involved a 20-year-old woman who was referred to our hospital for crown-root fracture of her maxillary teeth. A radiographic examination revealed complicated crown-root fracture of the maxillary right lateral incisor and both maxillary central incisors. The central incisors were treated with intentional replantation with 180-degree rotation. At the 48-month follow-up, the fractured teeth were found to have regained normal function based on clinical and radiographic examination. Limited case reports are available on a long-term follow-up of intentional replantation with 180-degree rotation. These two cases, particularly case 2, presented optimal healing after 4 years with unideal crown-root ratios. This case report suggests that this old method of preserving teeth with crown-root fractures can be used as a last resort to save teeth owing to its timesaving and microinvasive procedure.

Traumatic injuries to the permanent dentition are most common in children. In severe dentoalveolar injuries, especially avulsion and intrusion, dentoalveolar ankylosis is a common complication, leading to adverse effects on the developing alveolar bone and interfering with the eruption of the adjacent teeth. The decoronation procedure was suggested in 1984 to reduce these side effects related to ankylosis. The objective of the current publication is to describe a minimally invasive, flapless decoronation procedure aimed to minimize and simplify the surgical procedure of decoronation, and ease its clinical acceptance, particularly in young children. The technique is described in a detailed protocol and demonstrated in two cases. Under local anesthesia, the dental crown is removed, and the root is reduced by 1.5-2.0 mm apically to the marginal bone crest. The root canal content is then removed, allowing it to fill with blood. The socket is coronally sealed with a porcine-derived collagen matrix (PDCM) sutured using the "parachute" technique over the resected root, allowing close adaptation to the surrounding soft tissue. In conclusion, the presented technique of flapless decoronation is a modification of the classic decoronation procedure, which can be used as a minimally invasive technique to simplify the surgical procedure and the post-operative process.

Background: The healing period from crown lengthening procedures (CLPs) often delays the final crown delivery. This study aimed to explore the feasibility of a new approach expediting the delivery of the final crowns for teeth requiring CLPs., Methods: Teeth requiring CLPs and single-crown restorations between the canine and the second molar were included. After the initial tooth preparation, a CLP was performed. In the experimental group, the final tooth preparation and final impression were made during the CLP; the final crown was then delivered at the suture-removal appointment. In the control group, the final impression was made 8 weeks after the CLP. The level of gingival margin (GM), pocket depth (PD), and crestal bone levels (CBLs) were compared between the two groups before CLPs (T0), at delivery of the crowns (T1), and at 12 months in function (T2)., Results: Twenty-one lithium-disilicate crowns were delivered to 20 subjects and followed up. The mean interval between the CLPs and the delivery of crowns was 2.5 weeks for the experimental group and 12 weeks for the control group. No significant differences were observed between the two groups in the level of GM, PD, and CBLs at each time point. No significant treatment difference in crestal bone loss was observed between the two groups at T2 (Experimental = -0.11 mm, Control = -0.03 mm; p = 0.67)., Conclusion: Making the final tooth preparation and the final impression at the CLP significantly reduced the time between the CLP and the delivery of the final crown and showed comparable clinical outcomes., (© 2022. The Author(s).)

The removal of impacted teeth is a common office-based oral and maxillofacial surgical procedure. Complications associated with the procedure are uncommon; however, in the mandible, close proximity of the third molars to the inferior alveolar nerve can potentially lead to temporary or permanent sensory disturbances. The intentional partial odontectomy (coronectomy) procedure is a surgical option aimed at mitigating and reducing the incidence of this potential risk and complication.

Background: Whether to preserve a structurally compromised tooth or remove it is a dilemma often encountered by clinicians. The aim of this study was to assess the long-term success rate of fractured teeth preserved by modified crown lengthening surgery and restorations., Methods: Thirty-nine patients with a total of 45 fractured teeth who had received modified crown lengthening surgery were recruited and examined. Numbers of teeth lost were recorded, and the criteria for successful teeth were defined. Kaplan-Meier estimator was used to determine the success rate. Possible risk factors were compared between successful and unsuccessful groups by a Cox regression analysis to explore the potential predictors of failure with a significant level at α = 0.05., Results: The mean ± SD of success time without considering variants was 6.2 ± 0.6 years (95% CI 5.1-7.7). The mean survival rates ± SD at 1.0-, 2.0-, 3.0-, 5.0-, 7.0-, and 9.0-year intervals was 97.8 ± 2.2%, 92.2 ± 4.4%, 72.8 ± 7.9%, 68.2 ± 8.6%, 60.7 ± 10.5%, and 40.4 ± 13.6%, respectively. Failure cases in teeth with poor plaque control and step-shaped fracture margin were significantly more than those with good plaque control and knife-shaped fracture margin (HR = 7.237, p = 0.011; HR = 15.399, p = 0.006; respectively)., Conclusions: Fractured teeth treated with modified crown lengthening surgery are anticipated to have a high clinical success rate for 6.2 ± 0.6 years. Plaque control and fracture morphology appeared to be significantly associated with the success of the multidisciplinary treatment approach., (© 2022. The Author(s).)

Background: Extraction of mandibular third molars (M3M) close to the inferior alveolar nerve (IAN) has a higher risk of neurological disturbance. This review aims to evaluate the evidence supporting the use of the coronectomy technique compared to complete extraction for such M3Ms. Case studies by a specialist oral and maxillofacial surgeon are included to illustrate clinical practice., Methods: Three databases (Cochrane Library, Embase, PubMed) were searched (November 2020). Additional articles were sought by hand searching the reference list of included articles. All studies published in English comparing outcomes of coronectomy with complete extraction with at least 50 subjects and 6 months follow-up were included., Results: Of the six included studies, five reported a lower rate of IAN disturbance after coronectomy compared with complete extraction. There were no reported cases of lingual nerve disturbance. Other outcomes of coronectomy such as pain, infection, alveolar osteitis were either similar or lower compared to complete extraction. There were high rates of root migration but low rates of exposure and reoperation. Follow-up protocols varied considerably., Conclusions: There is medium quality evidence to support the option of coronectomy for high risk M3M cases. Further studies to develop follow-up protocols to assist general dental practice is warranted., (© 2021 Australian Dental Association.)

Abstract: Nerve injury especially inferior alveolar nerve (IAN) is the one of the complications that occur when the mandibular third molar (M3) is extracted and in case of high risk patients, coronectomy might be an alternative to tooth extraction. The purpose of this retrospective study was to analyze root migration and its influencing factors at 6 months after coronectomy in both 2- and 3-dimensions using periapical view and cone-beam computed tomography (CBCT). We analyzed 33 cases of root remnant after coronectomy and measured the amount of migration in CBCT. The following factors that could possibly affect root migration were also analyzed: age, gender, number of M3 roots, shape of M3s, Pell, and Gregory classification, mesiodistal (MD) angulation, buccolingual (BL) angulation, contact point with the second molar, root curvature, and complete removal of the coronal portion. Migration of greater than 2 mm was found in 64% of the roots in the 2-dimensional (2D) analysis, and the average root migration was 4.11 mm in the 3-dimensional (3D) analysis. The factors affecting migration were the root morphology, complete removal of the coronal portion, impaction depth, and MD angulation in the 2D analysis, and MD and BL angulation in the 3D analysis. Ensuring sufficient space for root migration especially considering angulation, depth and complete removal of the coronal portion might be important factors after coronectomy of the M3. Root remnant after coronectomy of M3 may migrate in young patients who has sufficient empty coronal space and this may reduce the nerve damage by the separation of IAN and M3., Competing Interests: The authors have no conflicts of interests to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Anterior teeth with subgingival fractures require a multidisciplinary management approach with regards to biological, functional and aesthetic factors. This case report emphasises the use of a minimally invasive technique combined with a sequence of therapies to treat a complicated crown-root fracture and reviews the critical factors to ensure predictable outcomes. Endodontic treatment was undertaken due to exposure of the pulp in a complicated crown-root fracture of the maxillary right central incisor. Extrusion of the fractured fragment was performed to expose the fracture margin under the alveolar bone. Modified crown-lengthening surgery was used to reconstruct the biologic width. The traumatised tooth was restored with a glass fibre post and resin core, which fit the biological requirements. Finally, an all-ceramic crown fulfilled biomimetic aesthetics. This multidisciplinary approach achieved a good long-term prognosis with regards to periodontal and periapical healing.

Purpose: The coronectomy technique is an alternative to conventional impacted tooth removal which aims to reduce the risk of damage to the inferior alveolar nerve (IAN). The technique is usually performed by senior oral surgeons or residents in training. Herein, patients were treated in a single service, in which coronectomy was performed by an undergraduate dental student on partially erupted lower third molars., Methods: A prospective analysis was performed on 21 individuals submitted to a total of 35 coronectomies. Clinical and radiographic follow-up was performed for at least 12 months., Results: Overall, healing was within normal limits, without major complications and without permanent IAN injury. However, one case showed temporary IAN paraesthesia resolved within a month and two required repetitions of coronectomy due to the remaining enamel, but with a good final result. Root migration was observed in all cases, but no other surgery was required., Conclusion: Coronectomy may be an important option for treating partially erupted teeth in close nerve relationships, which could also be performed by trained undergraduate dental students. This series is interesting because it can encourage oral and maxillofacial surgeons to train undergraduate students and to stimulate their attraction and passion for surgery.

Purpose: Coronectomy is performed to avoid injury to the inferior alveolar nerve when mandibular third molars (M3s) in close proximity to the inferior alveolar nerve are indicated for extraction. Concern has been raised regarding the fate of submerged roots with exposed pulp tissue and whether this will serve as a nidus for infection. The study purpose was to answer the following clinical question: Among patients undergoing coronectomy, do those treated with concurrent root canal treatment (RCT), when compared with those not treated with RCT, have a decreased frequency of postoperative infections? The specific aims of this study were to 1) perform a comprehensive review to compare postoperative infection rates in M3 coronectomies with and without concurrent RCT and 2) review relevant animal and human studies pertaining to pulpal physiology as it relates to coronectomy., Materials and Methods: The study was designed as a comprehensive review to identify controlled studies that compared outcomes of M3 coronectomies with and without concurrent RCT published through January 2020. Studies included in the sample needed to meet the following criteria: 1) studies published in English, 2) human studies, and 3) studies that reported the postoperative infection outcomes. The predictor variable was concurrent RCT at the time of coronectomy. The outcome variable was postoperative infection., Results: The database search identified 107 publications for initial review. After application of the inclusion and exclusion criteria, the final sample included only 1 publication. The frequencies of postoperative infection with and without concurrent RCT were 87.5% and 12.5%, respectively., Conclusions: The one study identified for detailed review showed that RCT at the time of coronectomy does not decrease the frequency of postoperative infections. This result supports the recommendation that it is unnecessary to perform concurrent RCT on M3 roots that are retained. The finding that intentional submersion of roots does not require RCT also is supported by multiple animal and human studies., (Copyright © 2020 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Coronectomy is an alternative surgical technique for the management of high-risk third molars. It involves the removal of the crown of a tooth and the deliberate retention of the roots, thereby avoiding injury to the inferior alveolar nerve (IAN). Previous studies have suggested that it reduces the risk of nerve injury when compared with surgical extraction. The purpose of this study was to systematically review the incidence of complications following coronectomy such as IAN injury, pain, dry socket, infection, root migration, and need for re-operation. A comparative cost analysis of coronectomy and surgical extraction was done based on the results of the review. This provides an insight into the economic implications of the two procedures. A search through the MEDLINE database via Ovid, PubMed, Scopus, EMBASE via Ovid, and Web of Science, was carried out to extract randomised and non-randomised controlled trials. Four studies fulfilled the inclusion criteria. A meta-analysis was conducted to measure the overall effect of each outcome. The pooled odds ratio (OR) for IAN injury was 0.16 (95% CI 0.01 to 0.39). Coronectomy reduced this risk by 84%. Dry socket may occur less frequently following coronectomy whereas infection did not show a higher incidence with either intervention. Root migration was found to occur in 13%-85% of cases and the average incidence of re-operation was 2.2%. The ratio of the average costs was 1.12 favouring coronectomy if cone-beam computed tomography (CBCT) was not done prior to the procedure. If a scan was taken routinely for coronectomy, the cost ratio marginally favoured extraction. Coronectomy reduced the risk of nerve injury in high-risk third molars. Definitive conclusions, however, cannot be made for outcomes such as the need for re-operation, which may alter the cost ratio of coronectomy:extraction, as higher quality studies with longer follow-up are needed., (Copyright © 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

In recent years, coronectomy of impacted lower third molar teeth has become an increasingly popular alternative to removal. Traditionally, orthopantomograms of mandibular third molars have been used to indicate features that show that the tooth is in close proximity to, or in an intimate relation with, the inferior dental nerve. Some authors advocate coronectomy as opposed to surgical removal to reduce the risk of damage to the nerve. In our Trust during the last two years, there has been a noticeable increase in the prescription of coronectomy for the management of pericoronitis associated with mandibular third molars. The purpose of this study therefore was to examine the differences among clinicians in their assessment of the need for coronectomy using plain-view radiographs. An online survey was completed by 25 clinicians with different levels of experience from six units across the UK and Republic of Ireland. We found a wide variation in the number of coronectomies prescribed (intraclass correlation 2.67), and when prescribed, a lack of agreement about the radiographic feature that had influenced the decision. These judgments are not straightforward. They are, to some extent, subjective, and in certain cases may benefit from a team-led approach., (Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.)

Objectives: The aim of this study was to determine the increase in heat production, preparation time, and cutting surface quality of conventional, high-speed rotating instruments and piezoelectric preparation for coronectomy procedures., Materials and Methods: One hundred intact extracted molars were sectioned horizontally, sub-totally, 1 mm under the cemento-enamel line with five methods: (1) tungsten carbide torpedo (TcT), (2) round (TcR) drills using a conventional speed surgical straight handpiece (< 40,000 min -1 ), (3) tungsten carbide fissure (TcF), (4) diamond torpedo (DT) drills using a surgical high-speed, contra-angle handpiece (~ 120,000 min -1 ), or (5) a saw-like piezoelectric tip (PT). Temperatures, preparation times, and cutting surface irregularities were registered and the differences were analyzed with ANOVA, Tukey's HSD post hoc test (temperature, time) and with chi-square test (irregular surface)., Results: Rotating instruments produced a maximal temperature increase of less than 1 °C. TcF produced the least heat (ΔT = - 3.92 °C to the baseline), while PT produced significantly the highest temperature increases (ΔT = 12.38 °C, p < 0.001). Tungsten carbide drills were the fastest for coronectomy (from 55.9 to 64.3 s), while DT (169.7 s) while PT (146.8 s) were significantly slower. TcT and TcR drills produced an irregular root surface more frequently., Conclusions: During coronectomy, rotating instruments produced entirely acceptable heat, while PT produced unacceptable temperatures. Tungsten carbide drills performed coronectomies effectively, but the diamond torpedo and PT seemed clinically questionable. Considering heat, speed, and the cutting surface quality simultaneously, TcF in a surgical high-speed handpiece seems to be the best choice for coronectomy., Clinical Relevance: The correct insert can significantly reduce excessive heat and operation time during coronectomy procedures.

Introduction: A systematic review and meta-analysis were conducted to report combined and individual weighted pooled outcome rates for crown resection (CR) and root resection (RR) procedures., Methods: Three electronic databases (PubMed [MEDLINE], Scopus, and the Cochrane Library) were searched to identify human studies in 12 languages on CR (hemisection, trisection, and premolarization) and RR (amputations and RRs without removal of crown portions). Five peer-reviewed journals, references of relevant publications, and reviews were hand searched. Assessment by 3 independent reviewers was based on the following predefined Population, Intervention, Comparison, Outcome, Study Design question: "For teeth in patients undergoing surgical therapy by CR versus RR, what is the expected probability of survival according to longitudinal studies with strictly defined outcome measurements and inclusion/exclusion criteria?" Clinical investigations with at least 12 months of follow-up were included. Studies and level of evidence were appraised using the Newcastle-Ottawa Scale and Grading of Recommendations, Assessment, Development and Evaluations., Results: Thirty-four articles were obtained for final analysis. Data could be extracted from 19 studies (CR and RR OVERALL: N = 2667 [19 studies], CR: n = 111 [3 studies], and RR: n = 1127 [9 studies]). A random effects model showed weighted mean survival rates of 85.6% (95% confidence interval [CI], 76.7-91.5) for CR and RR procedures OVERALL. Individual data showed weighted mean survival rates of 81.9% (95% CI, 72.0-88.8) for CR and 87.2% (95% CI, 71.7-94.8) for RR. There was no statistically significant difference between CR and RR (P = .89, odds ratio calculation) or between maxillary and mandibular molars (P = .81, Fisher exact test)., Conclusions: Overall, CR and RR procedures showed good outcome rates. Large-scale randomized controlled trials should be conducted to strengthen the evidence., (Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Coronectomy is a widely accepted treatment for mandibular third molars that are in close relationship to the mandibular canal. However, long-term studies on morbidity following this procedure have not been presented. The aim of this study was to examine the long-term morbidity after coronectomy, with sensory disturbances of the inferior alveolar nerve (IAN) and root migration as the primary outcome variables. A total of 231 mandibular third molar coronectomies were performed in 191 patients with a mean follow-up period of 5.7years (range 1-12years). The prevalence of IAN injury was 1.3%, and 3.5% of the retained roots were removed. None of the reoperations to remove the retained roots caused IAN impairment. Infections occurred in 11.7% of the cases and all were treated with antibiotics. Overall, 97% of the retained roots showed signs of migration and 65% showed signs of rotation. Therefore, coronectomy of the mandibular third molars with an intimate relationship to the mandibular canal seems to be a safe treatment modality with a good long-term prognosis., (Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

This case report shows the treatment of a severe traumatic tooth injury. For the maxillary right central incisor, the trauma was considered a complicated crown-root fracture. The level of the fracture line, the length of the remaining root segment, and the presence and condition of the tooth fragment determined the type of therapy. Traumatized teeth with fractures below the alveolar crest are often considered hopeless. As this report shows, the treatment of a complicated crown-root fracture in the esthetic region can be challenging. Orthodontic extrusion and crown-length surgery were performed to bring the fracture line above the alveolar bone crest. A multidisciplinary approach was required for complete rehabilitation of the traumatized maxillary incisor. Suggestions are made to improve treatment planning of complicated crown-root fractures., (Copyright © 2018 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Crown reduction and vital pulp therapy is an accepted treatment for abnormal occlusion resulting in palatal trauma caused by malpositioned mandibular canine teeth in dogs and cats. This article describes use of mineral trioxide aggregate for vital pulp therapy after crown reduction. A list of materials and commonly used equipment is provided.

Aim: Damage to the inferior alveolar nerve (IAN) while extracting lower third molars is often caused by the intimate relationship between the nerve and the roots of the teeth. The aim of this study was to compare the sequelae of coronectomy with odontectomy in impacted mandibular third molars., Patients and Methods: This study included thirty patients which were divided into two groups, Group-I (test group) including 15 patients undergoing coronectomy and Group-2 (control group) of 15 patients undergoing odontectomy. Investigations included digital orthopantomogram. The parameters for this study included pain, swelling, nerve paresthesia, trismus, postoperative infection, postoperative wound dehiscence, postoperative pocket depth, and migration., Results: In Group-1 (coronectomy group), the patients underwent follow-up for 6 months to evaluate migration of the retained mandibular third molar root which was in proximity with the IAN. There was a mean increase in migration when the distance from the inferior border of IAN until the apex of the retained mandibular third molar root was measured which was by 3.43 mm after 6 months of follow up., Conclusion: On statistical analysis, the result in this study showed no statistical difference in both the groups in all the parameters that were taken., Competing Interests: There are no conflicts of interest

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., (Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Coronectomy was introduced as a treatment for impacted lower third molars at high risk of inferior alveolar nerve damage. Root migration is considered one of the common surgical complications of this procedure. This study aimed to investigate the long-term behaviour of retained root(s) after coronectomy. This was a prospective study, with 3-5 years of follow-up, of patients who underwent lower third molar coronectomy. Panoramic radiographs were taken preoperatively and at 1 week, 6, 12, 24, 36, and 60 months postoperative. Root migration patterns were recorded. Factors including age, sex, type and pattern of impaction, and root form were analyzed with respect to the root migration rate. A total of 356 coronectomies were performed in 254 patients. Most root migration was found to occur within 6 months (91.1%) and 12 months (61.4%) postoperative. From 24 months onwards, less than 5% migrated further. Age was found to be a factor affecting root migration: migration decreased with increasing age (by 0.203mm less per year increase in age). Other factors investigated were found to be unrelated. Therefore, adequate preoperative warning should be given to young patients considering coronectomy as treatment for impacted lower third molars. However, it should also be noted that the incidence of root exposure leading to re-operation is low., (Copyright © 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Crown-root fracture is one of the most challenging fracture types in the dental traumatology literature. Traumatized anterior teeth require quick functional and esthetic repair. In the case of a complex crown fracture of the maxillary left central incisor, requiring endodontic treatment, a fiber-reinforced post was used to create a central support stump to restore the dental morphology. This report describes the clinical procedures involved in the treatment. After two years of follow-up, the clinical and radiographic findings demonstrated that the adopted clinical protocol was successful and yielded healthy periodontal tissues with no signs of periradicular pathology.

Complicated crown-root fractures are considered rare occurrences in young permanent dentition; however, they pose a particularly difficult clinical challenge, especially when the traumatized tooth is immature. Two cases of complicated crown-root fractures of immature incisors are presented. In both cases, vital root submergence with no treatment to the exposed pulp was introduced as a stage in a complex treatment plan with the primary goal of preserving the shape of the alveolar ridge in the traumatized area until the root was completely formed or facial growth was finished. No inflammatory symptoms were detected either radiographically or clinically during the 15- and 16-month follow-up periods. In the chosen clinical cases, vital root submergence followed by orthodontic space maintenance can be beneficial to young patients if other treatment options are limited by the depth of the crown-root fracture or if the patient suffers from high dental fear and presents a particularly low level of compliance.

Rehabilitation of missing decoronated permanent incisors in growing children and adolescents is a major challenge. The psychologic impact of the loss of an incisor is significant due to its immediate influence on facial appearance. Final restoration is planned only after skeletal growth cessation. Consequently, the fabrication and installation of an immediate temporary restoration, which is expected to remain in place for a long period, must meet the patient's esthetic demands and be durable in the oral environment. Several proposed removable and fixed restorations have presented significant shortcomings. The purpose of this report is to suggest a comfortable dental device for restoring the missing permanent tooth with improved esthetic, functional, and psychologic benefits. An alternative fixed orthodontic laboratory fabricated appliance for permanent tooth restoration is described among children with posttraumatic tooth decoronation. Unlike removable restorative appliances, this fixed device is not dependent on the child's compliance. Esthetically, no metal part is exposed in the anterior region and the architecture is more sturdy and stable, with minimum interruption to the alveolar ridge's vertical development., Case Report: An alternative fixed orthodontic laboratory appliance is described for intermediate restoration of a missing permanent tooth., Clinical Relevance: A posttrauma intermediate fixed orthodontic appliance is a beneficial solution from esthetic, psychologic, functional, and economic perspectives for replacing missing anterior maxillary teeth. This device may be worn by patients for a long period until final restoration is indicated.

Coronectomy of lower impacted wisdom teeth is the partial removal of third molars, aiming to avoid inferior alveolar nerve injuries. The coronectomy procedure has several crucial points, such as the pulpal, periapical preoperative conditions of the tooth, the way of crown sectioning and decoronation, the wound closure and the length of patients' follow up. In addition it is important to identify and manage possible intraoperative or postoperative complications correctly. According to the literature, the complication rate of coronectomy is usually lower, than that of total teeth removal, furthermore considering inferior alveolar nerve injuries, coronectomy is significantly the safer procedure. The aim of the authors was to review the relevant literature, defining the indications, contraindications and the correct implementation of the coronectomy and to demonstrate the causes and incidences of failures and complications. Further aim was to promote the domestic acceptance of this procedure. Orv Hetil. 2017; 158(45): 1787-1793.

The aim of this systematic review was to evaluate the incidence of damage to the inferior alveolar (IAN) and dental nerves in successful coronectomies, and to compare the results with coronectomies that failed. To the best of our knowledge no such analyses have been reported. Between January 1990 and October 2016 we surveyed published papers to find those that examined clinical outcomes after coronectomy. Fourteen met the criteria for final inclusion. Of 2087 coronectomies, 152 failed (7%). Successful procedures were associated with a low overall incidence of injury to the IAN (0.5%) and lingual nerve (0.05%). The incidence of injury to the IAN in failed coronectomies was 2.6%. The incidence of permanent paraesthesia was 0.05% in successful coronectomies and 1.3% in those that failed. No permanent injury to the lingual nerve was reported. Mobility (36%, 55/152) and migration or exposure (33%, 50/152) of roots were the most common underlying causes of failure. Coronectomy seems to be safe, but it depends on the patient and the technique used. To ensure adequate assessment of postoperative complications, we strongly recommend systematic evaluation of the reduction in sensitivity of the lower lip, chin, or tongue, and a standard follow up., (Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Purpose: To report the long-term outcomes of 78 adult patients who underwent coronectomy with bone grafting (CWG) of the bony crypt., Materials and Methods: Seventy-eight patients with follow-up of at least 5 to 9 years underwent CWG. Preoperative imaging and probing depths were recorded, as were yearly follow-up radiographs or cone-beam computed tomograms and yearly postoperative probing depths., Results: Periodontal probing depths and bone levels on the distal surfaces of adjacent mandibular molars showed marked improvement compared with preoperative probing depths and bone levels. All retained roots maintained their immediate postoperative positions with no migrations and no reoperations required., Conclusion: CWG is a predictable procedure that should be considered for patients at risk for developing sensory disturbances or for those with deeper (>4 mm) preoperative probing depths on the distal surfaces of the adjacent molars. Adding bone graft appears to aid in preventing root migration and decreasing probing depths on the distal surfaces of adjacent molars., (Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

The purpose of this case series is to describe a restorative and surgical approach to treat the combined defect (CD)-gingival recession associated with noncarious cervical lesions (NCCL)-through connective tissue graft in combination with partial resin composite filling, restoring the crown zone plus 1 mm of the NCCL. A total of 10 patients were included. Bleeding on probing, probing depth, relative gingival recession, clinical attachment level, CD height, and dentin hypersensitivity were measured. The treatment provided statistically significant gain in clinical attachment level and shallow probing depths. The percentage of the combined defect coverage was 70% ± 20.2%. It can be concluded that this treatment protocol, in the presence of a partial resin composite restoration, can be used successfully to treat CD.

Objective: To observe the long-term clinical treatment outcome and the influencing factors of the outcome for the teeth receiving modified crown lengthening surgery combined with root canal treatment and post-core crown restoration. To summarize the clinical guidelines of modified crown lengthening surgery in selection of indications and for mulation of treatment planning. Methods: Fifty-seven patients with a total of 67 teeth receiving modified crown lengthening surgery combined with root canal treatment and post-core crown restoration for at least a 6 months' follow-up period between July 2004 and July 2013 were recruited in this retrospective study by phone call interviews. The patients' clinical outcomes were evaluated by the combination of clinical examination, radiograph and questionnaire regarding patient-reported outcome of the last follow up (≥9 months post modified crown lengthening surgery and ≥6 months after definite crown restorations). All of the treated teeth were classified into two groups, group A (teeth with good clinical treatment outcome) and group B (teeth with poor clinical treatment outcome), based on the defined criteria including patients' satisfaction with the function and esthetics of the teeth and absence of periodontal, endodontic and prosthodontic complications. The potential influencing factors of clinical treatment outcome were also determined by Logistic regression analysis. Results: Vertical root fracture in 1 tooth was found on its periapical film and the tooth was deemed hopeless. Thus, the survival rate is 99% (66/67) for the multidisciplinary treatment approach. Seventy-two percent (48/67) of the teeth achieved good clinical treatment outcome and 28% (19/67) of the teeth developed one or several complications. In group B (teeth with poor clinical treatment), 16 out of teeth exhibited periodontal complications with bleeding on probing (BOP) positive mostly found. Logistic regression analysis demonstrated that plaque control ( OR= 21.392, P= 0.014), edge form ( OR= 7.610, P= 0.011), and smoking experience ( OR= 7.315, P= 0.018) were the risk factors influencing the clinical treatment outcome of modified crown lengthening surgery combined with root canal treatment and post-core restoration. Conclusions: Modified crown lengthening surgery combined with root canal treatment and post-core restoration has a good and stable clinical effect in the observational time of 6-114 months. Plaque control, smoking status and edge form of the tooth appeared to be the influencing factors of this multidisciplinary treatment approach.

Our aim was to describe the postoperative morbidity related to secondary wound healing after coronectomy. Ten of 116 patients treated by coronectomy healed by second intention as a result of failed sutures. We made a retrospective analysis after two years to evaluate the postoperative morbidity related to secondary wound healing. The complete closure of the alveolus of the 10 surgical sites was recorded three months after coronectomy. No patients had postoperative infections, dry socket, or pulpitis. All patients were free of symptoms, the retained roots were completely included, and were not detectable with a periodontal probe. The importance of primary wound closure after coronectomy has been stressed as a critical point to avoid postoperative infection of the root. We found that secondary wound healing after coronectomy was not associated with a high postoperative infection rate, but further randomised clinical studies are necessary to confirm the need for primary closure and its relations to the long-term success of the coronectomy., (Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)