Non-Cochrane · intervention · PM42022697
Coronectomy Versus Total Extraction for Third Molar Surgery: A Systematic Review and Meta-Analysis.
Derbishi Ali A, Altayyar Raand A, Alsubaiei Abdulaziz S, et al. · Cureus · 2026 · PubMed · doi:10.7759/cureus.105646
Findings
Population Patients with mandibular third molars at radiographically high risk of inferior alveolar nerve injury
16 findings
| Coronectomy (intentional partial odontectomy) | Total surgical extraction | Inferior alveolar nerve injury (temporary or permanent) Follow-up 6 to 36 months Unresolved: the two extractors disagree on this row. | Peto OR 0.23 [0.13, 0.39] -63 [-69, -47] per 1,000 patients Moderate Downgraded: risk of bias, imprecision 6 studies · 1140 participants |
| Coronectomy (intentional partial odontectomy) | Total surgical extraction | Dry socket (alveolar osteitis) Follow-up 1 to 4 weeks · Study design: RCTs | RR 0.50 [0.00, 2209946.15] GRADE not reported 3 studies · 625 participants |
| Coronectomy (intentional partial odontectomy) | Total surgical extraction | Dry socket (alveolar osteitis) Follow-up 1 to 4 weeks · Sensitivity analysis (leave-one-out), omitting Kang 2019 | RR 0.69 [0.28, 1.70] GRADE not reported 6 studies |
| Coronectomy (intentional partial odontectomy) | Total surgical extraction | Re-operation to retrieve retained roots (pooled incidence after coronectomy) Follow-up 6 to 36 months | Proportion 0.012 [0.000, 0.044] 12 per 1,000 coronectomy teeth Low 7 studies · 759 participants |
| Coronectomy (intentional partial odontectomy) | Total surgical extraction | Dry socket (alveolar osteitis) Follow-up 1 to 4 weeks | RR 0.68 [0.33, 1.40] -18 [-38, 21] per 1,000 patients Low Downgraded: risk of bias, imprecision 7 studies · 1488 participants |
| Coronectomy (intentional partial odontectomy) | Total surgical extraction | Postoperative pain (VAS) Varied timing of pain assessments (for example day 1 versus day 7) | SMD -0.12 [-0.59, 0.34] GRADE not reported 4 studies |
| Coronectomy (intentional partial odontectomy) | Total surgical extraction | Postoperative infection Follow-up 1 week to 24 months | RR 0.87 [0.42, 1.79] -6 [-26, 35] per 1,000 patients Low Downgraded: risk of bias, imprecision 8 studies · 1430 participants |
| Coronectomy (intentional partial odontectomy) | Total surgical extraction | Inferior alveolar nerve injury (temporary or permanent) Follow-up 6 to 36 months · Absolute risk metric: number needed to treat (control event rate 6.17%) | NNT 21.2 GRADE not reported Studies not reported |
| Coronectomy (intentional partial odontectomy) | Total surgical extraction | Dry socket (alveolar osteitis) Follow-up 1 to 4 weeks · Sensitivity analysis (leave-one-out), omitting Renton 2005 | RR 0.54 [0.24, 1.20] GRADE not reported 6 studies |
| Coronectomy (intentional partial odontectomy) | Total surgical extraction | Dry socket (alveolar osteitis) Follow-up 1 to 4 weeks · Sensitivity analysis (leave-one-out), omitting Hamad 2024 | RR 0.94 [0.43, 2.06] GRADE not reported 6 studies |
| Coronectomy (intentional partial odontectomy) | Total surgical extraction | Dry socket (alveolar osteitis) Follow-up 1 to 4 weeks · Sensitivity analysis (leave-one-out), omitting Yan 2020 | RR 0.57 [0.22, 1.48] GRADE not reported 6 studies |
| Coronectomy (intentional partial odontectomy) | Total surgical extraction | Dry socket (alveolar osteitis) Follow-up 1 to 4 weeks · Study design: non-randomized studies (cohorts) | RR 0.59 [0.26, 1.31] GRADE not reported 4 studies · 863 participants |
| Coronectomy (intentional partial odontectomy) | Total surgical extraction | Dry socket (alveolar osteitis) Follow-up 1 to 4 weeks · Sensitivity analysis (leave-one-out), omitting Cilasun 2011 | RR 0.69 [0.29, 1.66] GRADE not reported 6 studies |
| Coronectomy (intentional partial odontectomy) | Total surgical extraction | Dry socket (alveolar osteitis) Follow-up 1 to 4 weeks · Sensitivity analysis (leave-one-out), omitting Leung 2009 | RR 0.74 [0.37, 1.46] GRADE not reported 6 studies |
| Coronectomy (intentional partial odontectomy) | Total surgical extraction | Dry socket (alveolar osteitis) Follow-up 1 to 4 weeks · Sensitivity analysis (leave-one-out), omitting Pang 2024 | RR 0.68 [0.33, 1.40] GRADE not reported 6 studies |
| Coronectomy (intentional partial odontectomy) | Total surgical extraction | Inferior alveolar nerve injury (temporary or permanent) Follow-up 6 to 36 months · Trial sequential analysis (fixed-effect Mantel-Haenszel, TSA-adjusted CI) | RR 0.19 [0.08, 0.50] GRADE not reported Studies not reported |
Included primary studies 8
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Al-Ali 2025 Standardized coronectomy versus total extraction for impacted mandibular third molars: a single-blinded prospective analysis of… PMID:40837146 | 2025 | this review only | not stated | not extracted yet |
| Cilasun 2011 Coronectomy in patients with high risk of inferior alveolar nerve injury diagnosed by computed tomography. PMID:21288616 | 2011 | this review only | not stated | not extracted yet |
| Hamad 2024 Outcomes of Coronectomy and Total Odontectomy of Impacted Mandibular Third Molars. PMID:37563080 | 2024 | this review only | not stated | not extracted yet |
| Kang 2019 Coronectomy: A Useful Approach in Minimizing Nerve Injury Compared With Traditional Extraction of Deeply Impacted Mandibular Third Molars. PMID:31356802 | 2019 | this review only | not stated | not extracted yet |
| Leung 2009 Safety of coronectomy versus excision of wisdom teeth: a randomized controlled trial. PMID:19782621 | 2009 | this review only | not stated | not extracted yet |
| Pang 2024 Third Molar Coronectomy vs Total Removal in Second Molar Periodontal Healing. PMID:37666687 | 2024 | this review only | not stated | not extracted yet |
| Renton 2005 A randomised controlled clinical trial to compare the incidence of injury to the inferior alveolar nerve as a result of coronectomy and… PMID:15620767 | 2005 | this review only | not stated | not extracted yet |
| Yan 2020 Somatosensory changes in Chinese patients after coronectomy vs. total extraction of mandibular third molar: a prospective study. PMID:31853899 | 2020 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients needing surgical management of mandibular third molars with radiographically confirmed high risk of IAN injury (root darkening, canal diversion or interrupted cortical white line) | 1,488 teeth in high-risk mandibular third molar patients (mean ages about 20.9 to 31.7 years); 8 studies |
| Intervention | Coronectomy (intentional partial odontectomy) | Coronectomy (n=794 teeth across 8 studies) |
| Comparison | Total surgical extraction | Total extraction (n=764 teeth across 8 studies) |
| Outcomes | Primary: IAN injury (temporary or permanent). Secondary: dry socket, infection, pain severity, root migration, re-operation | IAN injury (6 studies, n=1,140); dry socket (7 studies, n=1,488); infection (8 studies, n=1,430); pain (4 studies, SMD); re-operation (7 studies, n=759); root migration (narrative) |
| Study designs | RCTs and non-randomized clinical trials/prospective cohort studies | 3 RCTs and 5 non-randomized studies (4 prospective cohorts and 1 cross-sectional) |
| Timing | Not specified | Maximum follow-up 2 weeks to 36 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Yes | NRSI: Yes · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: No | NRSI: No · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |