Background: Surgical removal of impacted mandibular third molars located in close proximity to the inferior alveolar nerve (IAN) is associated with a risk of postoperative neurosensory disturbance. Coronectomy, or intentional partial odontectomy, involves removal of the crown while retaining the roots in situ and has been proposed as a conservative approach for high-risk mandibular third molars.

Objective: This study aimed to evaluate the clinical and neurosensory outcomes of coronectomy in patients with impacted mandibular third molars in close proximity to the inferior alveolar nerve.

Materials and Methods: A prospective single-arm clinical study was conducted among 20 patients treated at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Sana’a University, Yemen. Patients were aged 20–35 years and had impacted mandibular third molars considered to have a high radiographic risk of inferior alveolar nerve injury. Preoperative assessment included clinical examination, panoramic radiography, and cone-beam computed tomography (CBCT). Coronectomy was performed using a standardized surgical protocol. Postoperative outcomes included pain assessed using the Visual Analogue Scale (VAS), facial swelling assessed using Laskin’s scale, and neurosensory status. Patients were followed for 6 months.

Results: Of the 20 patients, 15 (75.0%) were female and 5 (25.0%) were male. The mean age was 26.65 ± 4.66 years. The mean VAS pain score decreased significantly from 5.60 ± 1.09 on postoperative Day 1 to 1.05 ± 0.60 on Day 7 (p < 0.001). No statistically significant differences in postoperative pain were found between age groups on Day 1 (p = 0.254) or Day 7 (p = 0.771), or between male and female patients on Day 1 (p = 0.163). No statistically significant association was found between age group and postoperative swelling severity (Fisher–Freeman–Halton exact test, p = 1.000) or between gender and postoperative swelling severity (Fisher–Freeman–Halton exact test, p = 0.356). One patient (5.0%) experienced temporary paresthesia, while 19 patients (95.0%) maintained normal neurosensory status.

Conclusion: Within the limitations of this small prospective single-arm study, coronectomy was associated with favorable short- and intermediate-term clinical and neurosensory outcomes in patients with impacted mandibular third molars in close proximity to the inferior alveolar nerve. Further studies with larger samples, appropriate control groups, and longer follow-up are required to evaluate the long-term effectiveness and safety of the procedure.