A coronectomy is a dental procedure that’s done in certain situations as an alternative to having a wisdom tooth extraction.

A coronectomy can be done when a dentist feels there’s an increased risk of injury to the inferior dental nerve. It may also be considered safer than an extraction in people over 40, according to some researchers.

Located in the very back of your mouth, your wisdom teeth are your third set of molars. They typically come in when you’re in your late teen years and are your last set of adult teeth.

For many people, one or more wisdom teeth don’t have enough room to grow properly and break (or erupt) through the gum. These wisdom teeth are referred to as being impacted.

Often, your dentist will suggest removing impacted wisdom teeth — called an extraction — because they tend to be prone to decay and disease.

A standard wisdom tooth extraction will remove the entire tooth, and sometimes all four are removed at once. A coronectomy will remove the crown of the tooth and leave the tooth’s roots in your jaw, intact.

A coronectomy isn’t recommended if the wisdom tooth or root is infected.

Both procedures may be done by a dentist or oral surgeon. Your dentist will likely decide on one procedure over the other depending on factors such as your age and likelihood of nerve damage.

Sometimes the wisdom teeth roots are close to, press on, or even wrap around your lingual nerve (LN) or inferior alveolar nerve (IAN), the nerves that supply feeling to your tongue, lips, and chin.

In situations like this, your dentist or oral surgeon might recommend a coronectomy as an option that could lower risk for potential nerve damage as compared to an extraction.

Damage to your LN and IAN might result in:

According to a 2015 review, extracting a wisdom tooth with roots near the IAN can cause direct or indirect damage to the nerve. Coronectomy in that situation can be a safe procedure that’s associated with a low incidence of injury to the lingual or inferior alveolar nerves.

According to other research from 2015, a coronectomy is preferable to extraction for preventing neurological damage when roots are near the IAN.

According to a 2012 study, a small percentage of people who’ve had a coronectomy will have roots erupt and later need to be extracted.

While rare, in these cases extraction is no longer a problem because the roots have grown away from the IAN.

A 2012 study suggests that coronectomy is a safer choice for people over age 40 because they have a higher risk of nerve damage.

A coronectomy isn’t commonly recommended for young people who need a wisdom tooth removed because the tooth’s roots are not fully formed. Younger people also tend to heal faster and better than older individuals.

Following your coronectomy, you’ll probably have some swelling and discomfort, although usually less than you would after a full extraction.

Your dentist will provide aftercare instructions and might prescribe antibiotics, although the risks of postoperative infection and dry socket is reduced as compared to extraction.

As with any dental procedure, if you notice any signs of infection, excessive bleeding, or other unusual symptoms, you should call your dentist or oral surgeon.

Typically a coronectomy is used when the tooth that needs to be removed has roots that are near important nerves. There are specific situations when a coronectomy is usually not recommended, such as:

  • the tooth is growing horizontally along the IAN
  • the tooth is infected
  • the tooth is loose

If you have impacted wisdom teeth, your dentist or oral surgeon will do a physical examination of your mouth and consult dental X-rays. They’ll then make recommendations regarding the best course of action, including surgical options.

The typical surgical option is a full extraction of the tooth (or teeth), but may also be a coronectomy in which the crown of the tooth is removed but the roots are left in place.

A coronectomy is often recommended when the tooth’s roots are close to important nerves, to avoid nerve damage. Speak with your doctor about the best procedure for you.