Removal of Lower Jaw Dentigerous Cysts and Partial Extraction Therapy (Coronectomy) to Protect the Mandibular Nerve

The Story:

This patient presented with bilateral mandibular cysts associated with her impacted wisdom teeth. The Cone Beam CT Scan (CBCT) shows cystic lesions in the lower jaw bone associated directly with the impacted third molars. The third molars were positioned quite deep in the jaw bone in close proximity to the inferior alveolar nerve (A sensory nerve to the lower teeth, gingiva, lip, and chin areas).


The treatment plan and surgical procedure included:

  • Partical extraction therapy (coronectomy) of lower third molars to protect the nerve from disturbance and probably long-term numbness
  • Enucleation (complete removal) of the cyst and submission for histology to verify diagnosis
  • Bone graft with platelet-rich fibrin to reconstruct the bony defects and restore the periodontal bony support behind the second molars.

The cyst was diagnosed as dentigerous cyst.
A follow-up and a second CBCT 6 months later showed proper healing of the bone graft and no recurrent. Patient had no disturbance of the inferior alveolar nerve with complete sensation intact.

Complete Treatment Progression: