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Coronectomy is a widely accepted technique for approaching impacted wisdom teeth. The fundamental principle is to prevent trauma to the inferior dental nerve (IDN). Many literature publications have demonstrated its positive outcomes. To the best of my knowledge there is no literature regarding coronectomy of deciduous teeth. This case report highlights the complex approach to managing a severely submerged LRE in the mixed dentition of a 10-year-old female. The report demonstrates and discusses the combined orthodontic and oral surgery approach to prevent damage to the IDN and to allow space for orthodontic movement. This case emphasises how delicate nerve sparing techniques in the mixed dentition are complex, yet achievable.Clinical relevance statement: When managing severely submerged and impacted deciduous second molars, clinicians must be aware that the options for a coronectomy should carefully be considered and may be the difference between sparing the nerve or causing permanent injury.http://dx. Background:Vestibuloplasty is a surgical technique to improve functional vestibular sulcus. The technique of vestibuloplasty with secondary epithelisation always results with high relapse rate which can be improved with grafting with palatal mucosal graft, however second site morbidity still be concerned.