Koronektomi – en litteraturgennemgang og to patienttilfælde
Koronektomi, sammensat af det latinske ord corona, som betyder krone, og det græske ord tomein, at skære. Ordet dækker over et alternativ til konventionel amotio af visdomstænder i situationer, hvor klinikeren skønner, at der er øget risiko for sensoriske forstyrrelser i nervus alveolaris inferior. Metoden består i at fjerne kronen på visdomstanden og efterlade rodkomponenten i knoglen. Korterevarende studier og case reports beskriver metoden som værende et sikkert alternativ med lavere incidens af nerveskader og kendetegnes desuden ved et relativt ukompliceret efterforløb, når de rigtige indikationer er til stede, og operationen varetages af personer med specialistuddannelse eller omfattende kendskab til dentoalveolær kirurgi. Artiklen tager udgangspunkt i en litteraturgennemgang, ligesom der beskrives to patienttilfælde; en 25-årig mand og en 36-årig kvinde, begge med recidiverende perikoronale infektioner og tæt relation til nervus alveolaris inferior.
Klinisk relevans:
Coronectomy - A literature review and two case presentations: Intentional partial odontectomy or coronectomy have received increased attention during recent years. The aspect of avoiding damage to the inferior alveolar nerve during third molar removal, as well as the tell tale signs of close relationship between the apex and the nerve, has lead to the proposal of coronectomy. When following the proper indications, the suggested procedure represents an apparently safe way of treating the patient. The literature, even though sparse, is positive with regards to long term outcome and accepts this surgical approach as a valid alternative to conventional third molar removal when the integrity of the inferior alveolar nerve could be compromised. The current article is a literature review where two clinical cases are described. The first case is a 25 year old man and the second case is a 36 year old woman. In both cases the patients reported repeated infections around a lower wisdom tooth and a close relationship to the inferior alveolar nerve was observed. This procedure should be reserved for dentists with a profound knowledge in dentoalveolar surgery or a specialist in oral and maxillofacial surgery.
