A regimen of systematic periodontal care after removal of impacted mandibular third molars manages periodontal pockets associated with the mandibular second molars.

Aim: This randomized, single-blinded control trial investigated the local effects of periodontal care on the mandibular second molar delivered during and after impacted third molar surgical extraction.

Method: Thirty subjects (50% male, 32.1+/-7.8 years) out of 35 enrolled, with a mesio-angular impacted mandibular third molar, having probing pocket depth (PPD) >5 mm at adjacent second molar distal, and crestal radio-lucency between the two teeth, completed the study. Oral hygiene instruction, scaling and caries stabilization were performed before surgery. Controls (n=16) had their third molar extracted followed by standard socket debridement. Test group subjects (n=14) received the same treatment, except that before wound closure the operator was informed of the group allocation and ultrasonic root debridement on the second molar was performed, followed by a three-visit plaque control programme.

Results: Six months post-extraction, statistically significantly (p<0.007) better plaque control and shallower probing depths were observed at test second molars' distal (%plaque=21; PPD=3.2+/-1.2 mm) than at control second molars (%plaque=88; PPD=5.2+/-0.7 mm).

Conclusions: The periodontal interventions investigated prevented residual pockets on periodontally involved second molars 6 months after ipsilateral impacted mandibular third molar removal.