Use of Collagen Membrane in the Treatment of Periodontal Defects Distal to Mandibular Second Molars Following Surgical Removal of Impacted Mandibular Third Molars: A Comparative Clinical Study.

Thiagarajan Ramakrishnan,Ashok Kumar Bhati,A Thirumal Raj,Shilpa Bhandi,Pradeep Devadoss,Mazen A Almasri,Zeeshan Heera Ahmad,Khalid J Alzahrani,Shankargouda Patil,Malath Suhluli,Rajaram Vijayalakshmi,C Burnice Nalina Kumari,Manea Musa Al-Ahmari,Hajar Saeed Al Dira

doi:10.3390/biology10121348

Abstract

Simple SummaryRegeneration of the wounded/lost tissues post-surgery often requires a meticulous treatment plan. The present study assessed the use of a collagen membrane to aid in the regeneration of lost periodontal tissues following extraction of the tooth. The results show that the collagen membrane promoted wound stabilization, as indicated by improvement in all assessed clinical parameters. Thus, collagen membrane can be used regularly in clinical practice post-extraction to augment wound healing.The study aims to assess the efficacy of using collagen membrane in the treatment of distal periodontal defects of mandibular second molars following the removal of mesioangularly or horizontally impacted mandibular third molars surgically. Forty sites in twenty patients with bilaterally impacted mandibular third molars (mesioangular or horizontal) were considered for the study. In 20 test sites (Group A), after surgical removal of the mandibular third molar, a resorbable collagen membrane barrier was placed on the distal aspect of the mandibular second molar to cover the post-surgical bone defect. In the other control 20 sites (Group B), the same surgical procedure was repeated without placing any membrane barrier. The clinical parameters recorded were Oral Hygiene Index Simplified (OHI-S), Probing pocket depth (PPD), Clinical attachment level (CAL), and radiographic assessment of alveolar bone level (ABL). OHI-S score of most of the patients was observed to be satisfactory. Group A was observed to achieve a statistically significant reduction in PPD, CAL, and ABL gain compared to Group B. The improvements indicated that the use of collagen membrane facilitates early wound stabilization and promotes primary closure of the defect. This recovery is achieved through its unique property to assist fibrinogenesis over osteoconduction. Further longitudinal studies are needed to confirm the present findings.

Highlights

Mandibular third molars vent out in the terminal end of the lower dental arch and are the most recurrently wedged [1,2]
The extraction of the affected third molar may lead to bone loss, increase in probing pocket depth, and introduction of the cementum on the distal aspect of the root surface of the nearby second molar
There is a danger that a periodontal bony defect at the distal aspect of the second mandibular molar will not heal after careful expulsion of not many sorts of affected impacted third molars in patients over 24 years of age [7,8,14]

Summary

Introduction

Mandibular third molars vent out in the terminal end of the lower dental arch and are the most recurrently wedged [1,2]. Literature on periodontal wound healing has brought about the improvement of the treatment methodology using guided tissue regeneration (GTR) [9,10]. The use of a membrane is expected to promote wound stabilization and defend the adhering clot from tensile forces onto the external portion of the membrane [11] This barrier allows the body to regenerate periodontal ligament, cementum, and bone [12]. The primary aim of the study was to assess the clinical efficacy of collagen membrane in treating periodontal defects on the distal aspect of mandibular second molars following trans alveolar extraction of impacted mandibular third molars. The secondary aim is to compare the periodontal defect resolution on the distal aspect of mandibular second molar with and without the placement of collagen membrane after transalveolar extraction of impacted mandibular third molars

Objectives

Methods

Results

Discussion

Conclusion