Koronektomija

master's thesis

• Title (english): Coronectomy
• Author: Gloria Križanić
• Mentor: Dragana Gabrić (mentor)
• Committee member: Dragana Gabrić (predsjednik povjerenstva)
• Committee member: Mato Sušić (član povjerenstva)
• Committee member: Vanja Vučićević-Boras (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Oral Surgery); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Oral Surgery

Abstract

U današnje vrijeme većina stomatologa svjesna je porasta broja tužbi nakon stomatoloških usluga i činjenice da nema prostora za pogreške i propuste. Najizvođeniji zahvat u oralnoj kirurgiji alveotomija je impaktiranih trećih molara, nakon koje sve češće dolazi do povrede donjega alveolarnog živca u donjoj čeljusti. Povreda može biti privremena ili trajna. No, bilo privremene bilo trajne naravi, izuzetno je neugodna, kako za pacijenta tako i za oralnoga kirurga. Postoje neke alternativne tehnike koje nastoje izbjeći ozljedu donjega alveolarnog živca. Među njima je i koronektomija ili parcijalna odontektomija prilikom koje uklanjamo krunu zuba dok korijen ostavljamo retiniran u kosti sprječavajući na taj način povredu donjega alveolarnog živca. Koronektomija posebno je korisna kod zubi čiji je korijen u dodiru s mandibularnim kanalom. Prilikom postavljanja indikacija, od velike su pomoći panoramska radiološka snimka (OPG) i CBCT snimka koja pokazuje odnos korijena zuba i mandibularnoga kanala u trećoj dimenziji. Koronektomiju još uvijek široko ne prihvaćaju oralni kirurzi, no svakim danom pojavljuje se sve više i više studija koje nam pomažu shvatiti one dobre karakteristike koronektomije. Jedno od najvažnijih saznanja jest da koronektomija smanjuje komplikaciju povrede donjega alveolarnog živca bez povećanja ostalih komplikacija u usporedbi s konvencionalnom alveotomijom.

Abstract (english)

Many dentists have lately become aware of the rapidly increasing number of lawsuits after dental procedures, which means there is little room for any unintentional errors or carelessness. The most widely performed procedure in oral surgery is removal of impacted third molars. One of the most common complications of the extraction of the impacted third molar is the injury of the inferior alveolar nerve (IAN). This injury has a sensory deficit as a consequence. Whether temporary or permanent it can be extremely unpleasant for both the patient and the oral surgeon. There are numerous alternative techniques which minimise the risk of nerve injury, one of them being coronectomy or intentional partial odontectomy. During this procedure the crown of the lower third molar is removed and a part of its root is retained in order to reduce the possibility of IAN injury. This procedure is especially advisable in cases where the root is in contact with the mandibular canal. The relationship between the roots of mandibular teeth and the IAN can be assessed radiographically, particularly with a panoramic radiograph. CBCT scanning can be used to visualize the relationship in the third dimension, and this imaging can be used to easily predict the indications for coronectomy. While the objective of this technique is very clear, it is not free of controversy, which is probably the reason it is still not widely performed by oral surgeons. There are more and more studies that prove its benefits. They all inarguably confirm that coronectomy reduces the possibility of IAN injury, and does not increase the rate of other complications compared to the conventional procedure of impacted third molar extraction.

• Keywords: impaktirani treći molari; koronektomija; parcijalna odontektomija; radiografska panoramska snimka; CBCT snimka; donji alveolarni živac
• Keywords (english): impacted lower third molar; inferior alveolar nerve; coronectomy; partial odontectomy; panoramic radiography; CBCT imaging
• Language: croatian
• URN:NBN: urn:nbn:hr:127:851872
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-08-28 10:59:11