Purpose: To estimate the prevalence of infrabony defects and their healing at the distal aspect of mandibular second molars (M2s) after extraction of impacted mandibular third molars (M3s).
Materials And Methods: This prospective clinical study included 22 young healthy patients (21.03 ± 4.51 yr old). Thirty-seven surgical extractions of high-risk periodontal and mesioangular impacted M3s in close contact with adjacent M2s were performed. Radiographic bone height (RBH), radiographic infrabony defects (RIDs), and bone loss (BL) were recorded at baseline and 3, 6, and 12 months after surgery. RBH and RIDs were measured from the tip of a periodontal gauge to the root apex and to the cementoenamel junction of the M2, respectively; BL was calculated by dividing the length of the M2 root into thirds and categorized as slight, moderate, or severe.
Results: Only 26 extracted teeth were included in all radiographic assessments. Mean RID size at baseline was 4.54 ± 1.87 mm. At 12 months, an average recovery of 2.80 ± 2.36 mm (P < .001) was recorded, for a mean RID size of 1.78 ± 1.65 mm. Statistically significant differences in RBH and RIDs were found at all assessments (P < .05). Improved bone healing was registered during the postoperative period, with higher values during the first 3 months (1.3 mm; P < .01). Most RIDs of at least 4 mm associated with moderate or slight BL decreased to no larger than 3 mm without BL. For moderate BL, the bone gain pattern was gradual and continuous, whereas for slight BL, the pattern was variable.
Conclusions: In young healthy patients, a high-risk periodontal impacted M3 leads to an RID of at least 4 mm associated with slight or moderate BL at the distal aspect of the M2, which decreases to no larger than 3 mm 12 months after surgery. Bone healing is clinically and statistically significant at 12 months, with the most notable changes at the first 3-month follow-up.
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http://dx.doi.org/10.1016/j.joms.2013.07.029 | DOI Listing |
J Periodontal Res
January 2025
Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Aim: This study aimed to evaluate and compare the results of combination therapy involving bone grafting and two different resorbable collagen membranes in 1-, 2- and 3-wall infrabony defects.
Methods: A total of 174 patients with infrabony defects (≥ 7 mm periodontal probing depth) were randomized to receive deproteinized bovine bone mineral (DBBM) with either a native porcine non-crosslinked collagen membrane (N-CM, control, n = 87) or a novel porcine crosslinked collagen membrane (C-CM, test, n = 87). Clinical parameters, including periodontal probing depth (PPD), clinical attachment level (CAL), and gingival recession (GR), were recorded at baseline, 12 weeks, and 24 weeks.
The integrity and phenotype of periodontal soft tissues significantly influence the outcome of surgical periodontal regenerative therapy. In cases with thin gingival phenotype, treating infrabony defects surgically can worsen gingival recession and loss of papillae. This report outlines a surgical approach for addressing infrabony defects at sites with gingival recession and thin phenotype.
View Article and Find Full Text PDFBioengineering (Basel)
December 2024
Department of Oral Biology, University Clinic of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090 Vienna, Austria.
Hyaluronic acid was proposed to support soft tissue recession surgery and guided tissue regeneration. The molecular mechanisms through which hyaluronic acid modulates the response of connective tissue cells remain elusive. To elucidate the impact of hyaluronic acid on the connective tissue cells, we used bulk RNA sequencing to determine the changes in the genetic signature of gingival fibroblasts exposed to 1.
View Article and Find Full Text PDFDent J (Basel)
November 2024
Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia.
: Impacted third molar extraction with a scalpel and rotary instruments is one of the most traumatic surgeries in dentistry. Therefore, it is necessary to discover less traumatic methods and instruments to reduce the risk of postoperative complications. : This study is reported in accordance with the CONSORT guidelines.
View Article and Find Full Text PDFClin Adv Periodontics
December 2024
Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Background: Recombinant human fibroblast growth factor-2 (rhFGF-2) has been shown to effectively promote the formation of new periodontal tissues, and its efficacy has been demonstrated in clinical settings. Moreover, the clinical and radiographic outcomes in the treatment of periodontal infrabony defects can be improved by using rhFGF-2 in combination with a bone substitute. Here, we present a case of four-wall bone defect in a tooth treated by combination regenerative therapy using rhFGF-2 and beta-tricalcium phosphate (β-TCP).
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