Coronectomy
on Wisdom Teeth
in Dallas–Fort Worth
When wisdom teeth are impacted and dangerously close to vital nerves, a full extraction isn’t always the safest option. DFWOMS offers coronectomy — a specialized procedure that removes the crown of the tooth while protecting the nerve — at our Irving, Mesquite, and Ennis locations.
A safer alternative when nerves are at risk
A coronectomy is an advanced surgical technique in which only the crown — the visible upper portion — of an impacted wisdom tooth is removed, while the roots are intentionally left in place. It is specifically designed for cases where the roots of a lower wisdom tooth are in very close contact with the inferior alveolar nerve, the nerve that controls sensation in the lower lip, chin, and teeth.
In these situations, attempting a full extraction carries a meaningful risk of nerve injury, which can result in numbness, tingling, or even permanent nerve damage. By leaving the roots undisturbed, our surgeons eliminate that risk while still resolving the problems caused by the impacted crown — giving patients a safer outcome without sacrificing results.
When is a coronectomy recommended?
Not every impacted wisdom tooth requires a coronectomy. Our surgeons use 3D Cone Beam CT imaging to evaluate each case individually and determine whether a full extraction or a coronectomy is the safer approach. A coronectomy is typically recommended when:
Every coronectomy at DFWOMS begins with a 3D Cone Beam CT scan that gives our surgeons a complete view of the tooth’s position, root anatomy, and its precise relationship to the inferior alveolar nerve. This level of detail allows us to determine with confidence whether a coronectomy is the right choice — and to execute it with sub-millimeter accuracy.
Why choose coronectomy over full extraction?
What to expect, step by step
We review your dental and medical history and take a 3D Cone Beam CT scan to precisely map the wisdom tooth’s position and its relationship to the inferior alveolar nerve. Based on this evaluation, our surgeons determine whether a coronectomy or a full extraction is the safest approach for your specific anatomy.
The procedure is performed under local anesthesia, IV sedation, or general anesthesia depending on your preference and the complexity of the case. All sedation at DFWOMS follows our opioid-free protocols, prioritizing your comfort and safety throughout.
Our surgeon makes a small incision in the gum tissue to access the impacted tooth. The crown is carefully sectioned and removed while leaving the roots completely undisturbed below the level of the surrounding bone. The site is then prepared for closure.
The gum tissue is sutured closed over the retained roots. Most patients experience mild to moderate soreness for a few days, managed effectively with our opioid-free pain protocol. You will receive detailed aftercare instructions before leaving our office.
We schedule follow-up visits to confirm healing and monitor the retained roots with periodic imaging. In most cases the roots remain stable and integrate with bone over time. We continue monitoring them to ensure no complications develop.
Specialized care for high-risk wisdom tooth cases
Common questions about coronectomy
Yes, in the right cases. Clinical studies consistently show that retained roots following a coronectomy remain stable in the vast majority of patients and rarely cause complications. Over time, they often integrate with the surrounding bone. Our surgeons select coronectomy only for patients whose anatomy and health make it the safest option, and we monitor the roots with periodic imaging during follow-up visits.
In most cases, no. Research shows that the retained roots migrate away from the nerve over time and rarely require a second procedure. In a small number of cases, the roots may need to be addressed at a later date if they become symptomatic — but this is uncommon. We monitor your progress closely to catch any changes early.
A standard extraction removes the entire tooth — crown and roots — in one procedure. A coronectomy removes only the crown and intentionally leaves the roots in the jawbone to avoid contact with the inferior alveolar nerve. It is a more specialized technique used specifically when the risk of nerve injury from full extraction is considered significant based on imaging.
Recovery is generally similar to that of a standard wisdom tooth extraction. Most patients experience mild to moderate soreness and swelling for 3–5 days and return to normal activity within about a week. Because the roots are not disturbed, the recovery is often more comfortable than a high-risk full extraction would have been. Detailed aftercare instructions are provided before you leave our office.
Coverage varies by plan. We work with most major dental insurance providers and accept Medicaid at all three of our locations. We also offer CareCredit and LendingClub financing. Our team will review your benefits before your procedure so you fully understand your options — contact us before your consultation.
The decision is based on a thorough clinical evaluation and 3D CT imaging that shows exactly how close your wisdom tooth roots are to the inferior alveolar nerve. You cannot determine this from a standard dental X-ray alone. At your consultation, our surgeons will review your imaging with you, explain the findings clearly, and recommend the approach that offers the safest and most effective outcome for your specific case.
Protect your nerve — preserve your smile.
If you have been told your wisdom teeth are close to a nerve, contact DFWOMS today. Our oral surgeons in Irving, Mesquite, and Ennis will evaluate your case and determine whether a coronectomy is the right choice for you.