Coronectomy Indication — MFDS Part 1 MCQ

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ModerateOral Surgery PrinciplesCoronectomy IndicationMFDS Part 1

For a mandibular third molar that has a clear therapeutic indication for surgical removal, which finding most strongly favours planned coronectomy rather than complete extraction?

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Reveal the answer and explanation

Correct answer: A — An intimate root–canal relationship creating a high risk of inferior alveolar nerve injury with complete removal

Explanation lettering: C = shown as B · D = shown as C · E = shown as D · B = shown as E

A is correct. Coronectomy is considered when a mandibular third molar genuinely requires removal but its roots are intimately related to the inferior dental canal, making complete extraction a high-risk procedure for inferior alveolar nerve injury. The crown is removed while suitable vital roots are retained. Non-vitality with apical disease, caries involving or threatening the pulp, intraoperative root mobility and cystic or other pathology requiring complete removal make intentional root retention inappropriate. CBCT may assist assessment after high-risk features are identified on conventional imaging, but it is not invariably required and guidance does not require CBCT confirmation of direct nerve contact in every case.

Reference: Faculty of Dental Surgery, Royal College of Surgeons of England. Parameters of care for patients undergoing mandibular third molar surgery, sections 'Coronectomy' and 'Indications for coronectomy', 2021. https://www.rcseng.ac.uk/-/media/Files/RCS/FDS/Guidelines/3rd-molar-guidelines--April-2021-v4.pdf