Dynamic Navigation-Assisted Coronectomy of a Deeply Impacted Mandibular Third Molar: A 5-Year Case Follow-Up

动态导航辅助下颌深埋阻生第三磨牙冠切术:5年病例随访

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Abstract

Coronectomy is a conservative surgical technique used to manage deeply impacted mandibular third molars at high risk of inferior alveolar nerve injury. Precise execution is essential to avoid complications, particularly in cases with limited surgical access. Dynamic navigation (DN) systems may enhance accuracy and safety in such procedures. This report describes the 5-year follow-up of a DN-assisted coronectomy in a 42-year-old patient presenting with recurrent pericoronitis and a pericoronal lesion associated with a deeply impacted lower third molar. Preoperative planning was performed using cone beam computed tomography (CBCT), and DN was employed intraoperatively to guide surgical instrumentation in real time. The procedure was carried out according to a standardized protocol, including crown sectioning, root reduction, and primary closure. No intraoperative or early postoperative complications were observed. At 5-year follow-up, the patient was asymptomatic. Clinical examination showed complete mucosal healing and normal probing depths. Radiographic evaluation revealed retained roots without signs of pathology and bone formation distal to the second molar. This case may highlight the potential role of DN in improving surgical control during coronectomy in anatomically complex situations, contributing to a favorable long-term clinical and radiographic outcome.

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