Effects Of Impacted Lower Third Molar Removal On Alveolar Bone Height And Periodontal Parameters Of Adjacent Second Molar

Introduction: The effect of surgical removal of impacted third molars on the periodontal parameters of adjacent second molar revealed inconsistent results. Some authors suggested improvement of periodontal parameters distal to second molar, whilst others demonstrated loss of attachment and reduction of alveolar bone height. This study was conducted to evaluate the alveolar bone height (ABH) and periodontal status of second molar after the surgery. Materials and Methods: Out of 42 subjects selected, 33 subjects completed the study. Only subject who had mesio-angular or horizontal impaction of third molar with available previous records of digital orthopantomogram (OPG) were recruited into the study. ABH of adjacent second molar on the previous OPG were compared with the current OPG using technique described by Krausz et al., (2005). Other paramaters such as probing pocket depth (PPD), bleeding on probing (BOP), recession (REC) were also recorded. Results: There was significant reduction (p<0.001) in mean ABH at distal of second molar between pre-surgery (4.30±1.09mm) and post-surgery (2.80±2.05mm). No significant different was found in ABH between 47 and 37 at baseline; (4.09±1.09mm vs 4.30±2.55mm) and post-surgery (3.00±2.20mm vs 2.70±2.35mm) where p<0.423. Distal sites of second molars consistently showed significantly higher mean PPD (3.76±1.32mm) when compared with mesial, mid buccal and mid lingual sites (p<0.001). Higher frequency of BOP (90.9%) were also recorded for distal sites. Conclusion(s): Within the limitation of this study, surgical removal of impacted third molars demonstrated significant reduction in ABH of second molar post surgically. Significantly deeper PPD were also recorded at distal sites as compared to other sites.

Download Full-text

Surgical Removal of the Fully Impacted Mandibular Third Molar: The Influence of Flap Design and Alveolar Bone Height on the Periodontal Status of the Second Molar

Journal of Periodontology ◽

10.1902/jop.1985.56.10.625 ◽

1985 ◽

Vol 56 (10) ◽

pp. 625-630 ◽

Cited By ~ 56

Author(s):

Trevor A. Chin Quee ◽

Denis Gosselin ◽

E. P. Millar ◽

John W. Stamm

Keyword(s):

Alveolar Bone ◽

Third Molar ◽

Surgical Removal ◽

Periodontal Status ◽

Second Molar ◽

Impacted Mandibular Third Molar ◽

Mandibular Third Molar ◽

Flap Design ◽

Bone Height

Download Full-text

Influence of Surgical Flap Design (Envelope and Szmyd) for Removal of Impacted Mandibular Third Molars on Clinical Periodontal Parameters: A Clinical Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094465 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4465

Author(s):

Muhtada Ahmad ◽

Zafar Ali Khan ◽

Tahir Ullah Khan ◽

Montaser N. Alqutub ◽

Sameer A. Mokeem ◽

...

Keyword(s):

Third Molar ◽

Periodontal Pocket ◽

Third Molars ◽

Chi Square ◽

Pocket Depth ◽

Clinical Attachment Loss ◽

Exact Test ◽

Second Molar ◽

Third Molar Extraction ◽

Flap Design

The aim of the study was to assess the influence of flap designs (Envelope flap (EF) and Szmyd flap (SF)) for impacted mandibular third molar extraction, on periodontal pocket depth (PPD), clinical attachment loss (CAL) and bone levels (BL) of second molar. Sixty patients indicated for third molar extractions with healthy second molars were allocated into two groups: EF and SF (n = 30). Third molars were assessed for angulation, root patterns, depth of impactions and relation with ramus (Pell and Gregory classification). Extraction of third molars was performed and PPD, CAL and BL around second molars at 0, 3 and 6 month (mon) follow-ups (FU) were assessed clinically and radiographically. ANOVA, Chi-square and Fisher’s exact test were employed to compare periodontal factors between EF and SF groups, considering p ≤ 0.05 as significant. Sixty participants with a mean age of 23.22 ± 3.17 were included in the study. Based on angulation, the most common impaction in the EF and SF groups was mesio-angular (EF, 50%; SF, 36.7%). Buccal and distal PPD showed a significant increase (p < 0.001) in both EF and SF patients from baseline to 6 mon. EF patients showed significantly higher distal and buccal CAL (6.67 ± 0.18 mm; 6.91 ± 0.17 mm) and BL (7.64 ± 0.16 mm; 7.90 ± 0.15 mm) as compared to SF patients (CAL, 6.76 ± 0.26 mm; 6.91 ± 0.17 mm-BL, 7.42 ± 0.38 mm; 7.34 ± 0.34 mm) at 6 mon FU. SF showed better soft tissue attachment (PPD and CAL) and bone stability (less bone loss) around second molars compared to EF after third molar extractions regardless of the patient, tooth and operator factors.

Download Full-text

Prevention of Periodontal Pocket Formation after Mandibular Third Molar Extraction Using Dentin Autologous Graft: A Split Mouth Case Report

Case Reports in Dentistry ◽

10.1155/2020/1762862 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Alberto De Biase ◽

Giulia Mazzucchi ◽

Dario Di Nardo ◽

Marco Lollobrigida ◽

Giorgio Serafini ◽

...

Keyword(s):

Case Report ◽

Third Molar ◽

Periodontal Pocket ◽

Pocket Depth ◽

Second Molar ◽

The Third ◽

Third Molar Extraction ◽

Probing Pocket Depth ◽

Surgical Extraction ◽

A Minor

Surgical extraction of the third molar can often result in the development of a periodontal pocket distal to the second molar that could delay the healing, and the socket could be colonized by bacteria and lead to secondary abscesses, or it may cause mobility or hypersensitivity. The aim of this case report is to assess the efficacy of a dentin autograft in the prevention of periodontal dehiscences after the surgical extraction of the third molar, obtained by the immediate grinding of the extracted tooth. A healthy 18-year-old male patient underwent surgery of both impacted mandibular molars: right postextractive socket was filled with grinded dentin; then, the left one was filled with fibrin sponge. The patient was followed up for six months, and clinical and radiographic assessment were performed: measurements of plaque index (PI), bleeding on probing (BOP), gingival index (GI), clinical attachment level (CAL), and probing pocket depth (PPD) were done before surgery and repeated at 90 and 180 days after the extractions. Measurements made at six months after the surgery revealed that the grafted site was characterized by a minor depth of the pocket if compared with the nongrafted site, with no clinical/radiographic signs of complications.

Download Full-text

Flap vs flapless technique for impacted third molar removal: A split mouth prospective randomized control study

Journal of Oral Medicine Oral Surgery Oral Pathology and Oral Radiology ◽

10.18231/j.jooo.2021.051 ◽

2021 ◽

Vol 7 (3) ◽

pp. 167-171

Author(s):

Neeraj ◽

Banshilal Beniwal ◽

Padmanidhi Agarwal ◽

Vikas Berwal ◽

Richa Malik

Keyword(s):

Healing Process ◽

Third Molar ◽

Mouth Opening ◽

Third Molars ◽

Pocket Depth ◽

Second Molar ◽

Group I ◽

Flap Design ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

The aim of this study was to compare the post-operative sequelae of removal of impacted third molars in participants treated with conventional flap elevation technique or with a minimally invasive flapless technique. Participants with bilaterally impacted mandibular third molars were included. They were divided into two sites constituting 2 groups. One group was operated by using conventional flap design and elevation and other with flapless technique. Objective clinical parameters were recorded and compared in the post-operative period like mouth opening, swelling, surgical time, and pocket depth. Subjective parameters including pain were also assessed and statistically analyzed. The sites operated in Group II (Flapless technique) had better results (p≤0.05) in terms of pain, swelling, trismus, and pocket depth distal to second molar when compared to Group I (Flap). The flapless technique gives better surgical results and improved healing process after third molar removal and so should be recommended in routine clinical practice.

Download Full-text

Effects of Collagen Membrane on Bone Level and Periodontal Status of Adjacent Tooth After Third Molar Surgery

10.21203/rs.3.rs-19864/v1 ◽

2020 ◽

Author(s):

Mert Ataol ◽

Adnan Kılınç

Keyword(s):

Alveolar Bone ◽

Third Molar ◽

Third Molar Surgery ◽

Collagen Membrane ◽

Pocket Depth ◽

Periodontal Status ◽

Second Molar ◽

Bone Level ◽

Secondary Healing ◽

Primary Healing

Abstract Background: After the surgical extraction of an impacted lower third molar, periodontal status and distal bone level of the adjacent second molar could be affected negatively. Healing type has been effected periodontal status and distal bone level of the adjacent second molar after third molar surgery. Absorbable materials have some benefits including promoting wound healing through isolation, clot and wound stabilisation, and haemostasis; enhancing primary wound coverage. The aim of this study was to compare primary and secondary healing and collagen-membrane-based primary healing after surgical removal of partially erupted impacted third molars (3Ms), evaluating the distal alveolar bone level (ABL) and periodontal status of the adjacent second molars (2Ms). Materials and Methods: Patients who met the inclusion criteria were randomised into three groups: secondary healing (n=28), primary healing (n=27) and membrane-based primary healing (n=29). Digital panoramic radiographs were obtained preoperatively (T1) and three months postoperatively (T2). The distances between the cemento-enamel junctions and the alveolar bone crests on the distal aspects of the adjacent 2Ms were measured using calibrated radiograph measurement software. The pocket depth and plaque index measurements were performed preoperatively and three months postoperatively. The periodontal plaque index (PPI) scores were registered on the distal aspects of the 2Ms, and the mean values were used. Results: Three of the applied healing types positively affected periodontal pocket depth (PPD) and periodontal index values (p<0.05). In terms of the ABL of the adjacent 2Ms, primary 3-4N/healing (p=0.001) and membrane-based primary healing (p=0.000) had superior results to secondary healing. Conclusion: Membrane usage is promising for the distal bone gain and periodontal status of the adjacent 2M.

Download Full-text

Incidence of neurosensory deficits following surgical removal of mandibular third molars: a prospective clinical study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20191633 ◽

2019 ◽

Vol 7 (5) ◽

pp. 1546

Author(s):

Thaufiq Ahamed M. I. ◽

Naveen Jayakumar ◽

Neelakandan R. S.

Keyword(s):

Tamil Nadu ◽

Statistical Significance ◽

Maxillofacial Surgery ◽

Inferior Alveolar Nerve ◽

Third Molar ◽

Lingual Nerve ◽

Surgical Removal ◽

Third Molars ◽

Post Surgery ◽

Mandibular Third Molars

Background: The aim of this prospective study was to determine the incidences of inferior alveolar nerve and lingual nerve deficit following surgical removal of impacted mandibular third molars and to evaluate the risk factors responsible for these postoperative neurosensory deficits.Methods: A total of 80 patients who reported to department of oral and maxillofacial surgery, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India requiring surgical removal of impacted mandibular third molar were included in this cross-sectional study. Standard surgical procedure was performed. All patients were reassessed one week post-surgery. Subjectively reported altered sensations were recorded and objective assessments were performed with light touch test, two-point discrimination threshold and pin-pick pain threshold. The collected data was analyzed using the chi square test to find out any clinical relevance.Results: There was no inferior alveolar nerve related neurosensory deficits and 6 (7.5%) resulted in lingual nerve related neurosensory deficits. The incidence of LN deficit for mesioangular, horizontal, distoangular was 1.3%, 3.8% and 2.5% respectively. Type of impaction assumed a mild statistical significance (p = 0.050).Conclusions: This study highlights the importance of careful preoperative clinical and radiographic assessment of patients where third molar surgery is planned. The surgical technique of third molar removal is also likely to have great impact on the outcome.

Download Full-text

Periodontal Conditions in Adult Patients with Cleft Lip, Alveolus, and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1992_029_0179_pciapw_2.3.co_2 ◽

1992 ◽

Vol 29 (2) ◽

pp. 179-185 ◽

Cited By ~ 14

Author(s):

Urs Bragger ◽

Ernst Schürch ◽

Gianni Salvi ◽

Thomas Von Wyttenbach ◽

Niklaus P. Lang

Keyword(s):

Periodontal Disease ◽

Cleft Lip ◽

Alveolar Bone ◽

Adult Patients ◽

Progression Rate ◽

Pocket Depth ◽

Probing Pocket Depth ◽

Periodontal Destruction ◽

Tissue Attachment ◽

Bone Height

The present study assessed the progression rate of periodontal disease over 8 years in a group of 52 adult patients with various forms of cleft lip, alveolus, and palate considered at risk for progression of periodontal disease. Of special interest was the evaluation of periodontal disease progression at sites adjacent to cleft regions compared to changes found at control sites not directly affected by such defects. High incidences of generalized plaque accumulation and bleeding on probing were noted at both examinations in 1979 and in 1987. A mean apical shift of the clinical attachment level amounting to 0.2 mm had occurred over the 8-year observation period. A slight apical displacement of the mesial and distal mean crestal alveolar bone was also noted. The rate of progression of periodontal disease over the 8 years was not found to be different at statistically significant levels at cleft sites compared to control sites. However, the results of this study documented that the cumulative periodontal destruction at 26 to 28 years of age was statistically significant and more pronounced at cleft sites as revealed by greater probing pocket depth and loss of clinical attachment. The differences between test and control sites amounted to 0.3 and 0.4 mm respectively for probing depth and 0.6 mm for loss of clinical attachment. In addition, the discrepancy between alveolar bone height and the levels of the clinical attachment at cleft sites demonstrated the presence of a long supracrestal connective tissue attachment adjacent to cleft defects. Therefore, the alveolar bone height as visualized in radiographs at such sites was considered an unreliable diagnostic tool for the assessment of the degree of periodontal destruction.

Download Full-text

Change in alveolar bone level of mandibular second and third molars after second molar protraction into missing first molar or second premolar space

European Journal of Orthodontics ◽

10.1093/ejo/cjz001 ◽

2019 ◽

Vol 41 (5) ◽

pp. 513-518 ◽

Cited By ~ 1

Author(s):

Un-Bong Baik ◽

Hong-Beom Choi ◽

Yoon-Ji Kim ◽

Dong-Yul Lee ◽

Junji Sugawara ◽

...

Keyword(s):

Alveolar Bone ◽

Linear Regression Analysis ◽

Third Molar ◽

Third Molars ◽

Panoramic Radiographs ◽

Second Molar ◽

Factors Associated ◽

Bone Level ◽

Pre Treatment ◽

Distal Aspect

Summary Objective To investigate the factors associated with the change in alveolar bone level of mandibular second and third molars after second molar protraction into the space of the missing first molar (L6) or second premolar (LE). Methods Fifty-one patients in whom space of the missing L6 or LE was treated with second molar protraction (13 males, 38 females, mean age 19.6 ± 4.7 years) from 2003 to 2015 were included. The alveolar bone level and position and angulation of the mandibular second and third molars were measured in panoramic radiographs at pre-treatment (T1), and after the alignment of the third molars following second molar protraction (T2). Factors associated with alveolar bone loss on the distal aspect of the mandibular second molars were assessed using linear regression analysis. Results Age at T1 (P < 0.001) and third molar angulation at T1 (P = 0.002) were significant factors for the prediction of alveolar bone level distal to the second molars. Limitation This study used two-dimensional panoramic radiographs, and we could observe only the interproximal bone level. Conclusions After second molar protraction into the missing first molar or second premolar space, mandibular second molars may exhibit alveolar bone resorption in the distal root in older patients and in those with mesially tilted third molars before treatment.

Download Full-text

Assessment of Lingual Nerve Paresthesia after Removal of Mandibular Third Molar

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i2231177 ◽

2021 ◽

pp. 253-259

Author(s):

V. Usha ◽

G. Rajabackiyam ◽

K. Prabhu Sankar ◽

Varun Muthuraman ◽

Aravind Christo ◽

...

Keyword(s):

Root Resorption ◽

Third Molar ◽

Lingual Nerve ◽

Surgical Removal ◽

Third Molars ◽

Second Molar ◽

Mandibular Third Molar ◽

Impacted Mandibular Third Molars ◽

The Common ◽

Mandibular Third Molars

Surgical removal of impacted mandibular third molars are the most commonly performed minor surgical procedures by maxillofacial surgeon. If not treated can lead to few complications like pericoronitis, root resorption of second molar, caries of second molar, cyst and tumours can arise from them. The common complications include swelling, hematoma, trismus and lingual nerve injuries. In this article 1000 cases of various types impactions were surgically operated and assessment of lingual nerve injury was done.

Download Full-text