Reviewed by Dr. Epstein
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Most wisdom teeth can be removed completely without affecting nearby areas. However, when a lower wisdom tooth is very close to an important nerve in the jaw, a coronectomy may be the safer option. It lowers the risk of nerve injury while still treating the part of the tooth most likely to cause problems.
We perform tooth extractions at our offices in Seattle and Shoreline
Table of Contents
What Is a Coronectomy?
A coronectomy is a specialized procedure used for certain lower wisdom teeth. Instead of removing the entire tooth, the surgeon removes only the crown while intentionally leaving the roots undisturbed. By leaving the roots in place, the risk of damaging the nerve during surgery is significantly reduced.
This approach is recommended only in carefully selected cases where imaging shows that the roots are closely associated with the inferior alveolar nerve. This nerve runs through the lower jaw and provides feeling to the lower lip, chin, and teeth. If it is injured during surgery, it can lead to temporary or, in rare cases, permanent numbness.
Coronectomy Procedure Details
During the procedure, a small incision is made in the gum tissue to access the impacted tooth. The tooth is then carefully sectioned, and the crown is separated from the roots.
Advanced techniques such as piezosurgery may be used to precisely remove bone around the impacted tooth while minimizing trauma to surrounding tissues. In selected high-risk cases, dynamic navigation technology may be used to provide real-time guidance during surgery, allowing your surgeon to precisely navigate around nearby nerves and other important structures.
Once the crown is removed, the roots are intentionally left undisturbed in the jawbone to protect the nearby nerve. The area is thoroughly cleaned, and the gum tissue is repositioned and closed with sutures.
In most cases, the retained roots heal without causing future problems. Occasionally, they may slowly migrate away from the nerve over time. If they later become exposed or symptomatic, they can often be removed more safely.
Advanced Wisdom Tooth Care
At Green Lake Oral & Facial Surgery, patient safety and comfort guide every step of care. Dr. Matthew Epstein is an expert in the removal of wisdom teeth, including complex and deeply impacted cases. He uses advanced 3D CBCT imaging and digital surgical planning to evaluate impacted wisdom teeth before recommending treatment.
When a coronectomy is appropriate, each procedure is carefully planned to reduce risk and protect long-term oral health. Techniques such as surgical navigation and piezosurgery are used to protect nearby nerves and surrounding structures.
Platelet-rich fibrin (PRF) may be used to support natural healing, while long-lasting anesthetics such as Exparel can reduce discomfort and decrease the need for narcotic pain medication. Clear post-operative instructions help support a smooth, predictable recovery.
Oral Surgeon in Seattle & Shoreline, WA
If you have been told your wisdom tooth is close to a nerve, an evaluation by an experienced oral surgeon can help determine whether a coronectomy or complete removal is the safest option.
To book an appointment at Green Lake Oral & Facial Surgery in Seattle, WA, call (206) 641-7212. To book at JAWNT Oral Surgery in Shoreline, WA, call (206) 848-5788.
FAQ
Is a coronectomy better than an extraction?
For patients whose wisdom tooth roots are very close to the inferior alveolar nerve, a coronectomy can reduce the risk of nerve injury. It is not appropriate for every impacted wisdom tooth.
What is the recovery time after a coronectomy?
Recovery after a coronectomy is similar to wisdom tooth removal. Most patients have mild swelling and soreness for a few days and can return to normal activities within a few days. Following post-operative instructions and maintaining good oral hygiene supports healing, which your surgeon will monitor during follow-up visits.
What are the downsides of a coronectomy?
While a coronectomy can reduce the risk of nerve injury, it does have some limitations. The retained roots may occasionally become exposed, infected, or require removal at a later time. In rare cases, the procedure may need to be converted to a full extraction if the roots become mobile during surgery.
Will I need another surgery after a coronectomy?
Most patients never require additional treatment. However, if the retained roots later become exposed or infected, your oral surgeon may recommend removing them.
Does a coronectomy leave a hole?
After the crown of the tooth is removed, the area is cleaned and the gum tissue is closed with sutures. As the site heals, the tissue fills in naturally, similar to the healing process after a standard wisdom tooth extraction.
