One of the anatomical difficulties with removing the lower wisdom teeth historically has been the presence of the Inferior Alveolar Canal. This is a nerve that goes down below your teeth and supplies the sense of pain and sensation to your lower jaw, gum tissue, teeth gums, lips, and parts of the tongue. When ever lower wisdom teeth are removed, there is always a level of risk that occurs in the possible injury to this nerve. Historically, we have not had any other option when these teeth need to be removed, but to take that risk as safe as possible.
However in the last decade a new procedure has be introduced in which we do a partial removal of the tooth.
You see one of the main problems with wisdom teeth is that when they only partially erupt, they create a large space behind them where food can get impacted. This is one of the main reasons for wisdom tooth infections. Some very clever surgeons thought what if instead of removing the whole tooth, we only take out the part that is causing the issue. The coronectomy procedure was born.
In this procedure the nerve is devitalized, and the top part of the tooth removed. The roots are then buried in the jaw bone and left in place. This procedure has 3 possible outcomes:
1. The root tips remain indefinitely in the jaw bone (most common outcome)
2. The roots start erupting and a few years later you feel some discomfort and an X-Ray shows the root tips have moved away from the nerve now. The surgeon can now go in and remove the roots without risk to the nerve.(happens a few of the time)
3. The root tips develop an infection and have to be removed, in which case you are back in the original boat as it pertains to risks. (rare)
This is a recent development in the management of wisdom teeth. It is important to have a discussion with Dr.Akmal as to whether this is something that is suitable in your specific case.
Post-Coronectomy procedure, with root moving away from nerve over time.