A Pilot Retrospective Study on the Effect of Bone Grafting after Wisdom Teeth Extraction.

Luigi Canullo,Francesca Camodeca,Paolo Pesce,Maria Menini,Giampiero Rossi-Fedele

doi:10.3390/ma14112844

Luigi Canullo, Francesca Camodeca + Show 3 more

Open Access

https://doi.org/10.3390/ma14112844

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Abstract

This study aimed to retrospectively investigate the effect of bone graft after extraction of wisdom teeth impacting with the distal aspect of the second molar, on soft tissue wound healing, bone loss, and periodontal parameters. Sixteen patients treated an for impacted mandibular wisdom tooth at least one year ago were re-called (18 teeth). Dental panoramic tomography and periodontal parameters were assessed. A graft material was used to fill the post-extractive sockets in the test group (GUIDOR easy-graft CRYSTAL), whereas in the control group, the socket was filled using a collagen sponge and blood clot (Hemocollagene, Septodont, Matarò, Spain). The radiographic bone loss was measured at the distal aspect of the second molar. The Wilcoxon singed-rank test for paired data was performed to evaluate statistical differences. In the test group, only two cases out of nine showed bone loss, with an average of 0.55 ± 1.30 mm. Conversely, in the control group, five teeth out of nine showed bone resorption with an average of 1.22 ± 1.30 mm. However, the differences were not statistically significant. Periodontal parameters at the second molar demonstrated similar behavior between the test and control groups. Soft tissue healing complications were lower in the grafted compared to the comparator sites without reaching statistical significance. Within the limitations of the present study, no difference was found between the two groups.

Highlights

Third molar (M3) extraction is one of the most frequent surgical interventions in everyday dental practice [1], and wisdom teeth are the teeth with the highest percentage of impaction, especially the mandibular ones [2]
Surgical removal of third molars has been associated with the risk of periodontal pockets development and bone loss on the distal aspect of the adjacent second molar [3,5,6,7,8], which can negatively affect the long-term prognosis of M2
Kugelberg et al found that 43.3% of second molars showed pocket depth (PD) greater than 7 mm and 32.1% exhibited bone loss exceeding 4 mm, after two-year follow-up following adjacent third molar extraction [5]

Summary

Introduction

Third molar (M3) extraction is one of the most frequent surgical interventions in everyday dental practice [1], and wisdom teeth are the teeth with the highest percentage of impaction, especially the mandibular ones [2]. Kugelberg et al found that 43.3% of second molars showed pocket depth (PD) greater than 7 mm and 32.1% exhibited bone loss exceeding 4 mm, after two-year follow-up following adjacent third molar extraction [5]. Due to these risks, the indication for third molar removal is the subject of controversy when considering the benefits and risks of the procedure, though the American Association of Oral and Maxillofacial Surgeons still suggests a prophylactic extraction to prevent the development of pathological alterations around third or adjacent second molars [9]. The development of periodontal complications at the distal aspect of the M2 has been associated with three important risk factors, such as: preexisting periodontal pocket (attachment levels > 3 mm), subjects age (age > 26 years), and the relationship of proximity and inclination of the M3 in relation to the M2 (horizontal or mesioangular impactions) [7,10]

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