We present the clinical case of a 25-year-old male patient who came for consultation due to repeated episodes of pain and inflammation around the lower left semi-included third molar. The medical history does not include any medical history of interest, the patient does not take any daily medication except antibiotics and anti-inflammatory drugs for the current problem, he is not a smoker and is in perfect health.

After the clinical examination, we requested an orthopantomography as the first diagnostic test. In it we can see how the wisdom tooth in question (38) is in close contact with the NDI canal, detecting radiological signs determined as clear indicators of high risk of injury to the nerve during extraction manoeuvres. Thus, curvatures are observed in the roots, darkening around the apices (mesial root) and an effacement of the upper cortex of the canal in contact with the distal root.
Although the orthopantomography showed a fairly clear image, we decided to request a CT scan in order to plan the case correctly before deciding on the therapeutic procedure. In the CT images we verified that the contact between the wisdom tooth and the NDI is real and that, therefore, the risk of damaging it during extraction is high.

In this situation, we inform the patient of the possibility of performing a coronectomy or partial extraction of the symptomatic third molar. With this technique we aim to eliminate the clinical symptoms caused by pericoronaritis, as we achieve a direct closure of the wound and the roots are included, preserving the integrity of the NDI.
The patient was informed of the possibility of an infectious complication of pulpal cause, which would force us to re-enter to complete the extraction. Re-entry would also be necessary if, in the long term, root migration were to occur, and the roots were to return to generate clinical pericoronaritis due to exposure. Only, if this occurs, the relationship of the roots to the NDI would probably no longer be as clear, and the extraction, therefore, not as compromised.
After obtaining the patient's informed consent, we decided to perform the coronectomy using the following surgical technique: Administration of antibiotic prophylaxis. Bayonet incision and lifting of a full-thickness flap similar to the one used for complete extraction of a wisdom tooth. Cutting of the crown with a fissure drill from the buccal table, following an angulation of approximately 45°. This section is complete so as not to exert force on the roots with the drills, which requires being very careful when approaching the lingual table so as not to injure the lingual nerve. Subsequently, further tooth tissue is removed, either with the same fissure bur or with a round bur from above. The latter is slightly easier than with the fissure drill. In this way, the section is at least 3 mm below the bone ridges. The aim is to allow the bone to regenerate over the roots and to enclose them in the jaw. The exposed root surface should not be treated. Finally, the remains of the follicle are removed, without mobilising the roots, the remaining tooth and the wound is sutured with loose stitches that are removed in one or two weeks. Radiological check-ups should be carried out at one month, six months and annually.

All these steps were carried out in our case, and the patient has not presented any complications in one year after the intervention.