Coronectomy vs Extraction for Wisdom Teeth in Canada
Thinking about wisdom tooth removal and hearing a new term, coronectomy? You’re not alone. For some Canadians, especially when a lower wisdom tooth’s roots sit right on the jaw nerve, a coronectomy can lower the risk of nerve damage while still solving pain, infection, or decay. Here’s how dentists and oral surgeons decide, what recovery is like, and how to choose confidently.
What’s better: coronectomy or extraction for wisdom teeth?
Neither is “better” for everyone. If a lower wisdom tooth’s roots are close to the inferior alveolar nerve, a coronectomy may reduce nerve-injury risk by removing only the crown and leaving roots. If the tooth is safely away from the nerve, full extraction is typically preferred. Your dentist or oral surgeon will confirm with X‑rays or CBCT.
First, what is a coronectomy?
A coronectomy is a partial removal of a lower wisdom tooth. The oral surgeon removes the biting portion (crown) but intentionally leaves the roots in place. The goal is simple: treat problems like decay or repeated infections while avoiding damage to the inferior alveolar nerve (IAN), which runs inside the lower jaw and provides feeling to the lower lip and chin.
Why not just extract the whole tooth?
With regular wisdom teeth, full extraction is standard. But if imaging shows the roots wrap around or touch the nerve canal, pulling the whole tooth can increase the risk of temporary or—rarely—permanent numbness or tingling. Typical estimates for lower third molar extraction put temporary IAN changes around about 0.5–1% and permanent changes lower than that. When risk markers are present on imaging, that risk can climb. In these cases, a coronectomy is considered to lower nerve-injury odds while addressing symptoms.
How do Canadian dentists decide?
The decision starts with a careful exam and radiographic assessment. Your team will review a panoramic X‑ray and often a 3D scan (CBCT) if the nerve is at risk. CBCT shows the precise relationship between the roots and the nerve canal, which helps plan the safest approach. To understand CBCT’s role better, see how 3D scans guide decisions in modern dental imaging.
Situations that point toward coronectomy
– The lower wisdom tooth is impacted and roots overlap or contact the nerve canal on CBCT.
– The crown is decayed, cracked, or causing gum infection (pericoronitis), but the roots look healthy.
– You’ve had past nerve symptoms or there are clear radiographic signs of high nerve risk.
Situations that point toward full extraction
– The tooth and roots sit safely away from the nerve.
– There’s cyst formation, severe root infection, or root mobility that makes leaving roots unwise.
– Your surgeon expects uncomplicated removal and better long‑term outcomes by removing everything once.
“There is insufficient evidence to determine whether asymptomatic disease‑free impacted wisdom teeth should be removed or retained.” — Cochrane Oral Health
Translation: not every wisdom tooth needs to come out. Your case should be individualized.
Pros and cons at a glance
Coronectomy pros
– Lower risk of inferior alveolar nerve injury when roots sit near the nerve.
– Often shorter numbness and faster return of normal sensation compared with high‑risk extractions.
– Addresses pain or infection related to the crown while preserving nerve safety.
Coronectomy cons
– Roots remain and need monitoring over time.
– In a minority of cases, roots can slowly migrate (move slightly upward) and may need a small follow‑up procedure if they erupt or cause irritation.
– Not suitable if roots are infected, loose, or associated with a cyst.
Full extraction pros
– One-and-done for many people: no roots left to monitor.
– Removes all tooth structure that could decay or get infected.
– Familiar procedure with clear aftercare steps.
Full extraction cons
– If roots are too close to the nerve, the risk of temporary or (rarely) permanent numbness increases.
– A slightly higher chance of nerve injury in specific high‑risk anatomy.
What does the procedure and recovery feel like?
Both options are usually done under local anesthesia, with sedation available if you’re anxious or facing a more complex surgery. Canadians often choose nitrous oxide or prescription oral sedation for comfort; IV sedation is another option in specialist clinics. If dental anxiety is a barrier for you, skim our plain‑English guide to options in sedation dentistry.
After a coronectomy
– You’ll bite on gauze to control bleeding and go home with written aftercare.
– Expect mild swelling and tenderness for a few days.
– Soft foods, lots of water, and no smoking or straws while the site stabilizes.
– Over‑the‑counter pain relief (ibuprofen/acetaminophen) is usually enough; your dentist will tailor advice to your health history.
After a full extraction
– Instructions are similar: rest, cold compresses the first 24 hours, and a soft diet.
– A slightly larger socket may mean a few more days of tenderness.
– You’ll watch for dry socket (a painful condition if the clot dislodges) and follow saltwater rinsing after 24 hours.
How often do roots migrate after coronectomy?
Studies show that root migration can occur in a portion of cases within the first year as the body remodels the area. Most of these movements are minor and don’t need treatment. Your dentist will monitor the site at routine checkups and suggest follow‑up imaging if anything changes or you notice symptoms. The aim is early, conservative management if the roots move toward the surface.
Is coronectomy only for bottom wisdom teeth?
It’s primarily used for lower (mandibular) wisdom teeth because that’s where the inferior alveolar nerve runs. Upper (maxillary) wisdom teeth are near the sinus, not the same nerve, so the risk profile and planning are different. Your surgeon will weigh those factors and explain the safest route.
What about costs and coverage in Canada?
Fees vary by province, procedure complexity, and sedation type. Many private dental plans reimburse wisdom tooth surgery, but coverage specifics differ. Coronectomy may be billed under a partial removal code. Ask your clinic for a pre‑estimate and have them check your benefits before you book. If cost is a concern, request options for staged care and medication‑first symptom relief if appropriate.
Choosing with confidence: how to prepare
Ask these questions at your consult
– Based on my imaging, what’s my estimated nerve‑injury risk with a full extraction?
– Would a coronectomy lower that risk in my case?
– Will you use CBCT to plan the procedure?
– What’s the plan if roots migrate or become symptomatic later?
– Which sedation options fit my health history and comfort level?
Get the right imaging
If your X‑ray suggests close root‑nerve proximity, a 3D scan helps map a safer path. Many Canadian oral surgery clinics have in‑house CBCT. That added clarity can be the difference between choosing coronectomy or extraction.
Plan your recovery window
Most people return to desk work in 1–3 days and light exercise after a few days, as advised by the surgeon. Have soft foods ready at home (yogurt, eggs, soups), and keep a follow‑up appointment on the calendar.
Real‑world example
Amira, 27, had recurring gum flares around a partially erupted lower wisdom tooth. CBCT showed the roots wrapped the nerve canal. Her surgeon recommended a coronectomy. Recovery was two quiet days at home and a week of soft foods. At six months, a checkup showed the site was healthy and comfortable. Two years later, the roots hadn’t moved enough to matter, and she’d had no more infections.
When extraction is still the right call
If a wisdom tooth has a cyst, widespread root decay, or loose roots, coronectomy usually isn’t appropriate. In those cases, full extraction removes diseased tissue and reduces the chance you’ll need a second surgery. If you want a deeper dive on deciding when removal makes sense, read our balanced take on wisdom tooth removal.
Key safety tips
– Don’t smoke or vape during healing; smoking slows blood flow and raises infection risk.
– Use a soft brush and gentle saltwater rinses after 24 hours to keep the site clean.
– Call if you get increasing pain, fever, bad taste, or swelling that worsens after day three.
Conclusion
Coronectomy and extraction are both effective tools—what matters is choosing the right one for your anatomy and goals. With careful imaging, a nerve‑aware plan, and clear aftercare, most Canadians do very well. If you’re still on the fence, book a consult with an oral surgeon, ask about CBCT, and bring your questions. For a step‑by‑step overview of the full removal pathway, you can also see what to expect during wisdom tooth removal.
FAQ
Is a coronectomy permanent, or will I need a second procedure?
Most coronectomies don’t need a second surgery. A minority of patients see small root migration that may require a simple follow‑up if the roots come close to the surface or cause irritation.
Can the retained roots get infected later?
It’s uncommon in healthy roots. Your dentist chooses coronectomy only when roots look clean and stable on imaging. Routine checkups help catch changes early if they occur.
Will I feel the roots?
No—roots remain under the gum and bone. If they migrate and you notice a new bump or tenderness, call your dentist for a quick evaluation.
Is coronectomy more expensive than extraction?
Fees vary by clinic and province. Sometimes they’re similar; sometimes coronectomy is slightly different in cost because of planning time and imaging. Ask for a written estimate and benefits check.
Does coronectomy hurt less than extraction?
Discomfort is similar for many people. Because the roots are undisturbed, some patients report milder post‑op nerve-related sensations. Good pain control and soft foods help either way.
What kind of anesthesia or sedation can I get?
Local anesthesia is standard. If you’re anxious or the case is complex, clinics may offer nitrous oxide, oral sedation, or IV sedation. Your medical history guides the safest choice.
