Abstract
This survey of expert opinion regarding the management of mandibular third molar (M3M)
impaction and its clinical sequelae was circulated to all members of the British Association
of Oral and Maxillofacial Surgeons (BAOMS). It was completed by 289 clinicians who
reported treating 60 003 patients annually. Respondents included 199 (69%) specialists and 58 (20%) primary
care clinicians. Most (99%) of the clinicians treated at least one M3M with complete
surgical removal (CSR) annually. Only 69% performed one or more coronectomies (COR).
Advocates of coronectomy reported lower rates of inferior alveolar nerve (IAN) injury,
but IAN, lingual nerve, and adjacent second molar damage were rare, occurring in less
than 0.5% of cases, with small differences between the COR and CSR groups. Although
these differences are not statistically significant, they are likely to be clinically
important. Also, the COR group would have comprised mainly high-risk teeth, while
the CSR group would include many teeth at low risk of complications. This might have
skewed the results. Those clinicians performing no coronectomies cited three main
reasons for being low adopters of COR: the lack of irrefutable evidence to support
its benefit, the increased need for a second operation, and more non-IAN complications.
Although COR may prevent permanent IAN damage in high-risk cases, this paper highlights
clinicians’ views that there is a gap in evidence and knowledge to support COR. As
a result, 47% of the clinicians surveyed recommended, and were prepared to participate
in, further studies to determine the effectiveness and safety of COR.
Keywords
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Article info
Publication history
Published online: March 04, 2020
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© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
