Coronectomy
Coronectomy Procedure is a specialized dental service provided by the board-certified specialists at Aloha Dental Specialty Center in Beaverton, OR. Removing the crown while leaving the roots to protect the inferior alveolar nerve.
When Removing the Whole Tooth Puts the Nerve at Unacceptable Risk
Not every impacted lower wisdom tooth should be extracted in its entirety. When CBCT imaging shows that the tooth roots are in direct contact with the inferior alveolar nerve canal — wrapping around it, grooving it, or perforating through it — complete extraction carries a meaningful risk of permanent nerve damage. Coronectomy is the deliberate, planned alternative: the crown of the tooth is sectioned and removed, eliminating the risk of cyst formation and infection, while the roots are left undisturbed in the bone, away from the nerve. The roots often migrate away from the canal over subsequent months, and if they ever cause problems, they can be removed later when they are no longer intimately associated with the nerve.
At Aloha Dental Specialty Center, coronectomy is reserved for cases where CBCT imaging demonstrates high-risk nerve proximity that conventional extraction cannot safely navigate. Dr. Ostovar has specific criteria: the nerve canal must be in direct contact with or deflected by the root on three-dimensional imaging. The tooth must not be acutely infected (active infection along the root surface could seed deep into the tissues if the root is left). And the roots must be sectioned at least 3mm below the bone crest so they are covered by bone and not exposed to the oral environment.
The coronectomy procedure involves raising a flap, exposing the tooth, sectioning the crown from the roots at a point below the alveolar crest, removing the crown, smoothing the root stumps with a bur, irrigating the site, and closing the flap. The root stumps are not disturbed — they are left to heal in place, covered by bone. PRF may be placed in the surgical site to promote soft tissue healing. Post-operative follow-up includes periodic imaging to monitor the root position and ensure no pathology develops around the retained roots.
Serving Beaverton, Aloha, Hillsboro & Washington County
Aloha Dental Specialty Center is located at 18455 SW Alexander St, Suite A, in Beaverton, Or 97003egon. We serve patients from across the Tualatin Valley and greater Portland metro, including Aloha, Hillsboro, Tigard, Lake Oswego, and Tualatin. Our Beaverton office is a 5-minute drive from Aloha, 10 minutes from Hillsboro, and 15 minutes from Tigard via SW 185th Avenue.
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Intel Campuses (Ronler Acres & Jones Farm)
10 to 15 minutes via NW 185th Ave. We accommodate the schedules of tech professionals who need efficient, high-quality specialty care.
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Nike World Headquarters
About 8 minutes via SW Baseline Rd. We frequently see patients from the Nike campus for surgical and implant procedures with sedation options.
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Streets of Tanasbourne & Orenco Station
Easily accessible via US-26 and NW 185th. Local general dentists in these communities regularly refer patients to us for specialty procedures.
Why Local Dentists Refer to Us
We work as a trusted partner to general dentists throughout the Tualatin Valley. When cases require CBCT-guided planning, IV sedation, bone grafting, or other advanced procedures, local providers refer to Dr. Ostovar for his fellowship-trained expertise and predictable results.
We handle the complex surgical phases and coordinate closely with your general dentist for smooth continuity of care from start to finish.
Understanding Your Investment
At Aloha Dental Specialty Center, we provide transparent pricing before any treatment begins. The cost of your procedure depends on clinical complexity, materials used, and sedation requirements. We walk you through every line item during your consultation so there are no surprises.
What Affects Cost:
- Clinical Complexity: Bone loss, sinus proximity, nerve involvement, or the need for grafting affects treatment planning and surgical time.
- Materials: We use research-backed implant systems, purified bone graft matrices, and high-strength ceramics from established manufacturers.
- Sedation: Options range from local anesthesia to IV sedation, each with different associated costs. We discuss the best option for your comfort and procedure.
Insurance & Financing
We accept most major dental insurance plans and file claims on your behalf. Our team verifies your benefits before treatment and submits pre-treatment estimates with clinical documentation to maximize coverage.
For out-of-pocket costs, we partner with CareCredit and Cherry for flexible payment plans. We also offer our ADSC Dental Savings Plan for patients without insurance.
Recovery & Healing Timeline
Understanding the healing process helps you plan ahead and follow post-operative instructions for the best possible outcome.
First 48 Hours
Mild swelling and tenderness are normal. Apply ice packs in 20-minute intervals and take prescribed or over-the-counter anti-inflammatory medication. Eat soft foods and avoid the surgical site when chewing.
Days 3 to 7
Swelling peaks around day three and then improves. The tissue begins closing over the surgical site. Continue with soft foods and use any prescribed antimicrobial rinse. Most patients return to normal activities during this phase.
Long-Term Healing
Surface tissue heals within two to three weeks. Bone integration and deep healing continue for three to six months. Avoid smoking, follow up as scheduled, and maintain good oral hygiene throughout recovery.
Questions during recovery? Call us at (503) 822-0096. We are available for post-operative concerns.
Root Migration and the Biology of Retained Root Fragments
After coronectomy, the retained root fragments undergo a phenomenon called root migration — they gradually move away from the inferior alveolar nerve canal in a coronal direction. Studies show that approximately 30-80% of retained roots migrate an average of 2-4mm over the first 6-12 months. This migration is driven by the absence of the crown (which removes the opposing eruptive force) and continued cellular activity at the root surface. The roots typically remain vital — the pulp is severed during sectioning but the apical blood supply through the periapical tissues maintains root vitality. If the roots migrate to a position where they are no longer near the nerve, secondary extraction can be performed safely if needed. Most retained roots, however, remain asymptomatic and do not require further intervention.
Why Choose a Specialist?
Coronectomy is a judgment call that requires both the imaging capability to identify high-risk anatomy and the surgical skill to execute the technique precisely. Cutting the crown at the correct level — deep enough to be covered by bone, shallow enough to leave the roots undisturbed — requires controlled sectioning in a confined space adjacent to a nerve. If the roots become mobile during sectioning, the plan may convert to complete extraction because a mobile root left in place can become infected. This decision-making during surgery, guided by preoperative CBCT planning and real-time assessment, is where fellowship training and daily surgical experience become indispensable.
Your Coronectomy Procedure Treatment Steps
- Consultation & Exam: Comprehensive coronectomy procedure evaluation with CBCT 3D imaging at our Beaverton office.
- Treatment Plan: Board-certified specialist discusses your coronectomy procedure options, timeline, and costs. Our procedures maintain a 95%+ success rate, backed by advanced 3D imaging and evidence-based protocols.
- Treatment: Procedure performed with comfort options including sedation if needed.
- Follow-Up: Post-treatment monitoring and care coordination for best healing.
Schedule Your Appointment Today
Book a consultation with our board-certified specialists at Aloha Dental Specialty Center in Beaverton, OR. Call (503) 822-0096 Office hours: Monday through Friday 7 AM to 7 PM, Saturday and Sunday 8 AM to 2 PM. or request an appointment online.
Related Services at Aloha Dental Specialty Center:
Dental Implants · Oral Surgery · Root Canal · Invisalign · Periodontics · Pediatric · TMJ Treatment · Sedation · Cosmetic · Emergency · Sleep Apnea
From Dr. Ostovar: What Patients Should Know
“I know oral surgery sounds intimidating — many patients tell me they’ve been putting this off for months or even years. Here’s what I want you to know: with IV sedation, you won’t remember anything. You’ll close your eyes, and the next thing you know, it’s done. Most patients say the anticipation was far worse than the reality.
Recovery depends on the complexity. For a straightforward case, you’re looking at 2-3 days of swelling managed with ice packs and ibuprofen, then gradual improvement over the following week. I recommend soft foods for 7-10 days — yogurt, scrambled eggs, mashed potatoes, smoothies. No straws, no smoking, no vigorous rinsing for at least 5 days.
I always use CBCT 3D imaging before any surgical procedure. A standard X-ray gives me a flat picture — the CT scan shows me exactly where the nerves are, what the bone looks like in three dimensions, and how to plan the safest approach. It makes a real difference in outcomes.”
— Dr. Merat Ostovar, DDS | Oral Surgery, Aloha Dental Specialty Center
Are You a Candidate for Coronectomy Procedure?
Most patients in good general health are candidates for coronectomy procedure. However, certain factors may affect your eligibility or require modifications to the treatment plan:
- Medical conditions: Uncontrolled diabetes, autoimmune disorders, or blood-thinning medications may require coordination with your physician before treatment.
- Bone quality: For coronectomy procedure involving the jawbone, adequate bone density is essential. A CBCT 3D scan during your consultation determines this precisely.
- Smoking: Tobacco use significantly impairs healing. We strongly recommend quitting 2-4 weeks before and after any surgical procedure.
- Age: There is generally no upper age limit. What matters is your overall health, not your age. We have successfully treated patients in their 80s and 90s.
The only way to know for certain is a consultation with our board-certified specialists. Call (503) 822-0096 to schedule your evaluation — we’ll tell you honestly whether this is the right treatment for your situation.
Typical Healing Timeline:
Days 1-3: Initial healing, mild swelling managed with ice and medication. Days 4-7: Swelling subsides, gradual return to normal diet. Weeks 2-4: Soft tissue heals completely. Months 2-6: Bone remodeling and full integration (for surgical procedures). Individual recovery varies — we provide detailed post-op instructions specific to your procedure.
For additional clinical information, visit the American Dental Association (ADA).
Last reviewed by our dental specialists: March 2026. Clinical information on this page reflects current evidence-based dental practices.
Related Dental Services
Frequently Asked Questions
What is a coronectomy?
A coronectomy is a surgical procedure that removes only the crown portion of a tooth while intentionally leaving the roots in the jaw. It is performed when complete extraction would pose an unacceptable risk of damage to the inferior alveolar nerve.
Why would you leave roots in the jaw on purpose?
When the roots are in direct contact with the nerve canal, extracting them risks permanently damaging the nerve — causing numbness of the lower lip, chin, and gums. By removing just the crown and leaving the roots undisturbed, we eliminate the pathology risk (cyst formation, infection) while protecting the nerve.
How do you know my roots are too close to the nerve?
CBCT three-dimensional imaging shows the exact spatial relationship between the tooth roots and the inferior alveolar nerve canal. Specific signs of high-risk proximity include: grooving or deflection of the nerve canal by the root, darkening of the root where it contacts the canal, and interruption of the white cortical outline of the canal.
Is coronectomy as effective as complete extraction?
Coronectomy effectively prevents the problems caused by impacted wisdom teeth — cyst formation, infection, and damage to adjacent teeth — because these pathologies originate from the crown and its surrounding follicle. The roots alone, when healthy and covered by bone, very rarely cause problems. Studies show coronectomy has a lower complication rate than complete extraction when roots are intimately associated with the nerve.
Can the retained roots cause problems later?
In approximately 2-5% of cases, retained roots may need to be removed later due to migration that brings them to the surface, infection, or pain. If removal becomes necessary, the roots will typically have migrated away from the nerve, making secondary extraction safer than the original extraction would have been.
How long does a coronectomy take?
A coronectomy takes approximately the same time as a surgical extraction — 30-45 minutes per tooth. The procedure is performed under local anesthesia with IV sedation available. The surgical approach is similar to extraction, except that the roots are left in place after the crown is removed.
What happens during recovery from a coronectomy?
Recovery is similar to wisdom tooth extraction: 5-7 days of swelling and discomfort, soft diet, and prescribed medication. The flap heals over the root stumps within 2-3 weeks. Long-term follow-up includes periodic X-rays to monitor root position and ensure no pathology develops.
What is the risk of nerve damage with coronectomy compared to extraction?
Studies show that coronectomy reduces the risk of inferior alveolar nerve injury to less than 1%, compared to 5-8% for complete extraction of teeth with roots directly on the nerve canal. This significant risk reduction is the primary reason coronectomy is recommended in high-risk cases.
What if the roots become mobile during the coronectomy?
If the roots become mobile during crown sectioning, the procedure converts to a complete extraction. A mobile root left in the jaw can become infected. This conversion occurs in approximately 5% of planned coronectomies and is managed immediately during the same surgical session.
Will I feel the roots that are left behind?
No. The roots are covered by bone and tissue. You will not feel them. They are below the level of the gum and the ridge surface. Over time, bone may form over and around them, further burying them from the oral environment.
How long do I need follow-up imaging after a coronectomy?
We typically take X-rays at 6 months, 12 months, and 24 months after coronectomy to track root position and check for pathology. If the roots are stable and no issues develop, imaging frequency decreases. Annual monitoring for the first few years is standard practice.
Can a coronectomy be done on teeth other than wisdom teeth?
Coronectomy is almost exclusively performed on lower wisdom teeth because they are the teeth most commonly associated with inferior alveolar nerve canal proximity. In rare cases, it may be applied to a lower second molar with similar high-risk anatomy, but this is uncommon.
Does insurance cover coronectomy?
Coronectomy is typically covered as a surgical extraction by dental insurance. The coding and coverage may vary by plan. We submit the claim with supporting documentation (CBCT images showing nerve proximity) to justify the procedure.
Is coronectomy a new procedure?
The concept has been in the literature since the 1980s, but it has gained wider acceptance over the past 15 years as CBCT imaging has made it possible to identify high-risk nerve relationships with precision. The evidence base supporting coronectomy as a safe alternative to extraction in nerve-adjacent cases is now strong.
Can I have a coronectomy on one side and a full extraction on the other?
Yes. Each tooth is evaluated independently. If one side shows high-risk nerve proximity and the other does not, we perform a coronectomy on the high-risk side and a standard extraction on the other. CBCT allows this individualized decision-making for each tooth.
Wisdom Tooth Roots on the Nerve? Coronectomy May Be the Safer Choice.
Call our Beaverton office or request an appointment online. We look forward to helping you.
Clinically Reviewed by Dr. Merat Ostovar, DMD
Doctor of Dental Medicine | Implant & Specialty Dentistry | 15+ Years Experience
Aloha Dental Specialty Center — Serving Aloha, Beaverton, Hillsboro & Greater Portland
Last updated: March 19, 2026