Comprehensive management of pericoronitis in lower third molars: extraction, operculectomy, and coronectomy approaches

Abstract

Pericoronitis is a common dental condition involving the inflammation of soft tissues around a partially erupted wisdom tooth, typically the lower third molars. It is most frequently diagnosed in young adults aged 20-29, with a higher prevalence in women. The condition often results from the accumulation of bacteria and food debris under the operculum, leading to infection and inflammation. Common symptoms include localized pain, gum swelling, trismus, and sometimes pus discharge. This study aims to discuss the types of clinical management of pericoronitis of the lower third molar as described in the literatureTooth extraction eliminates the source of inflammation, providing long-term relief but carries a higher risk of inferior alveolar nerve damage and greater postoperative discomfort compared to other methods.This minimally invasive procedure removes the gingival cap to prevent food and bacteria accumulation. It is suitable for patients with good oral hygiene and proper tooth angulation. Electrosurgery and laser methods reduce bleeding and swelling but have contraindications. Coronectomy, an alternative to extraction, avoids nerve damage by leaving the roots in place. Suitable for non-carious, pathology-free teeth, it shows lower risk of sensory disturbances and postoperative complications, though root migration may occur. Pericoronitis requires personalized treatment based on patient condition and tooth positioning. Thorough diagnostics and tailored approaches are crucial for effective management and improved outcomes.