Preventing Inferior Alveolar Nerve Injury Through Coronectomy: A Narrative Review

Coronectomy represents a conservative surgical alternative to complete extraction of impacted mandibular third molars when their close anatomical relationship with the inferior alveolar nerve (IAN) increases the risk of neurosensory injury.Although systematic reviews and meta-analyses support its effectiveness in reducing nerve-related complications, uncertainties remain regarding retained root migration, delayed complications, and long-term clinical outcomes.A narrative review of the literature was conducted using PubMed/MEDLINE, including publications available through September 2026.Twelve relevant studies were selected to examine the indications, neurological outcomes, postoperative complications, root migration, and long-term implications of coronectomy.Available evidence indicates that coronectomy is associated with a lower risk of inferior alveolar nerve injury than complete extraction in appropriately selected highrisk patients.However, retained roots may undergo postoperative migration, delayed exposure, or other complications occasionally requiring secondary surgical intervention.Long-term observational evidence remains limited, particularly regarding the predictability of retained root behavior.Overall, the available evidence supports coronectomy as a clinically relevant nerve-preserving alternative to complete extraction of high-risk impacted mandibular third molars.Careful patient selection, preoperative radiographic assessment, and individualized postoperative monitoring remain essential.Further prospective studies with extended follow-up are needed to clarify long-term outcomes and the risk of delayed complications.