Comparison of immediate vs. delayed guided tissue regeneration in Infrabony defect of second molars after adjacent third molar extraction: a retrospective study.


Journal

BMC oral health
ISSN: 1472-6831
Titre abrégé: BMC Oral Health
Pays: England
ID NLM: 101088684

Informations de publication

Date de publication:
23 Jul 2024
Historique:
received: 04 03 2024
accepted: 08 07 2024
medline: 24 7 2024
pubmed: 24 7 2024
entrez: 23 7 2024
Statut: epublish

Résumé

The distal aspect of the second molar (d-M2) often exhibits infrabony defects due to the adjacent third molar. Although the defects can be treated by guided tissue regeneration (GTR) after removing the third molar, the optimal timing remains uncertain following third molar removal in clinical decision-making. This study aimed to compare delayed and immediate GTR treatments to assist in clinical decision-making. D-M2 infrabony defects with a minimum 1-year follow-up were collected and divided into three groups: Immediate GTR group, which underwent third molar extraction and received GTR simultaneously; Delayed GTR group, which underwent delayed GTR at least 3 months after third molar extraction; and Control group, which underwent only scaling and root planing during third molar extraction. The clinical and radiographic parameters related to the infrabony defect before GTR and post-surgery were evaluated using the Kruskal-Wallis test or one-way ANOVA, followed by post-hoc Dunn's test or the Bonferroni test for pairwise comparisons. A total of 109 d-M2 infrabony defects were assessed. No significant differences were found between the two GTR groups, although both of them showed significant reductions in infrabony defect depth: the immediate GTR group (2.77 ± 1.97 mm vs. 0.68 ± 1.03 mm, p < 0.001) and the delayed GTR group (2.98 ± 1.08 mm vs. 0.68 ± 1.03 mm, p < 0.001) compared to the control group. GTR can effectively improve d-M2 infrabony defects when the third molar is removed, whether simultaneously or delayed. Patients may experience less discomfort with immediate GTR treatment as it requires only one surgery.

Sections du résumé

BACKGROUND BACKGROUND
The distal aspect of the second molar (d-M2) often exhibits infrabony defects due to the adjacent third molar. Although the defects can be treated by guided tissue regeneration (GTR) after removing the third molar, the optimal timing remains uncertain following third molar removal in clinical decision-making. This study aimed to compare delayed and immediate GTR treatments to assist in clinical decision-making.
METHODS METHODS
D-M2 infrabony defects with a minimum 1-year follow-up were collected and divided into three groups: Immediate GTR group, which underwent third molar extraction and received GTR simultaneously; Delayed GTR group, which underwent delayed GTR at least 3 months after third molar extraction; and Control group, which underwent only scaling and root planing during third molar extraction. The clinical and radiographic parameters related to the infrabony defect before GTR and post-surgery were evaluated using the Kruskal-Wallis test or one-way ANOVA, followed by post-hoc Dunn's test or the Bonferroni test for pairwise comparisons.
RESULTS RESULTS
A total of 109 d-M2 infrabony defects were assessed. No significant differences were found between the two GTR groups, although both of them showed significant reductions in infrabony defect depth: the immediate GTR group (2.77 ± 1.97 mm vs. 0.68 ± 1.03 mm, p < 0.001) and the delayed GTR group (2.98 ± 1.08 mm vs. 0.68 ± 1.03 mm, p < 0.001) compared to the control group.
CONCLUSION CONCLUSIONS
GTR can effectively improve d-M2 infrabony defects when the third molar is removed, whether simultaneously or delayed. Patients may experience less discomfort with immediate GTR treatment as it requires only one surgery.

Identifiants

pubmed: 39044179
doi: 10.1186/s12903-024-04591-1
pii: 10.1186/s12903-024-04591-1
doi:

Types de publication

Journal Article Comparative Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

830

Informations de copyright

© 2024. The Author(s).

Références

Kindler S, Holtfreter B, Koppe T, Mksoud M, Lucas C, Seebauer C, et al. Third molars and periodontal damage of second molars in the general population. J Clin Periodontol. 2018;45:1365–74.
doi: 10.1111/jcpe.13008 pubmed: 30168629
Zhi-bang L, Hong-lei Q, Li-na Z, Bei-min T. Fa-ming C. Influence of Non-impacted Third molars on pathologies of adjacent second molars: a retrospective study. J Periodontol. 2017;88:450–6.
doi: 10.1902/jop.2016.160453
Kugelberg CF, Ahlström U, Ericson S, Hugoson A. Periodontal healing after impacted lower third molar surgery. A retrospective study. Int J Oral Surg. 1985;14:29–40.
doi: 10.1016/S0300-9785(85)80007-7 pubmed: 3921477
Sun S, Yang Y, Zhi-bang L, Tian Y, Hong-lei Q, An Y, et al. How the loss of second molars corresponds with the Presence of adjacent third molars in Chinese adults: a retrospective study. J Clin Med. 2022;11:7194.
doi: 10.3390/jcm11237194 pubmed: 36498768 pmcid: 9739238
Jeong-Kui K, Yeong Kon J. Effectiveness of bone graft for an alveolar defect on adjacent second Molar after impacted mandibular third molar extraction. J Oral Maxillofac Surg. 2021;79:756–62.
doi: 10.1016/j.joms.2020.11.030
Castagna V, Pardo A, Lanaro L, Signoriello A, Albanese M. Periodontal Healing after Lower Third molars extraction: a clinical evaluation of different flap designs. Healthc (Basel). 2022;10:1587.
Zhang Y, Chen X, Zhou Z, Hao Y, Li H, Cheng Y, et al. Effects of impacted lower third molar extraction on Periodontal tissue of the adjacent second Molar. Ther Clin Risk Manag. 2021;17:235–47.
doi: 10.2147/TCRM.S298147 pubmed: 33790564 pmcid: 7997553
Passarelli PC, Lopez MA, Netti A, Rella E, Leonardis MD, Svaluto Ferro L, et al. Effects of Flap Design on the Periodontal Health of Second Lower molars after impacted third molar extraction. Healthc (Basel). 2022;10:2410.
Kumari CBN, Ramakrishnan T, Devadoss P, Vijayalakshmi R, Alzahrani KJ, Almasri MA, et al. 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. Biology (Basel). 2021;10:1348.
pubmed: 34943263
Toledano-Serrabona J, Ruiz-Romero V, Camps-Font O, Gay-Escoda C, Sánchez-Garcés. M-Á. A systematic review and meta-analysis on the effectiveness of xenograft to prevent periodontal defects after mandibular third molar extraction. Med Oral Patol Oral Cir Bucal. 2021;26:e414–21.
doi: 10.4317/medoral.24260 pubmed: 33037794
Singh M, Bhate K, Kulkarni D, Santhosh Kumar SN, Kathariya R. The effect of alloplastic bone graft and absorbable gelatin sponge in prevention of periodontal defects on the distal aspect of mandibular second molars, after surgical removal of impacted mandibular third molar: a comparative prospective study. J Maxillofac Oral Surg. 2015;14:101–6.
doi: 10.1007/s12663-013-0599-z pubmed: 25729233
Gasparro R, Sammartino G, Mariniello M, di Lauro AE, Spagnuolo G, Marenzi G. Treatment of periodontal pockets at the distal aspect of mandibular second molar after surgical removal of impacted third molar and application of L-PRF: a split-mouth randomized clinical trial. Quintessence Int. 2020;51:204–11.
pubmed: 32020130
Soo-Hoong L, Sao-Lun L, Hsein-Kun L. Evidence-based clinical decision making for the management of patients with periodontal osseous defect after impacted third molar extraction: a systematic review and meta-analysis. J Dent Sci. 2021;16:71–84.
doi: 10.1016/j.jds.2020.06.018
Thoma DS, Bienz SP, Figuero E, Jung RE, Sanz-Martín I. Efficacy of lateral bone augmentation performed simultaneously with dental implant placement: a systematic review and meta-analysis. J Clin Periodontol. 2019;46(Suppl 21):257–76.
doi: 10.1111/jcpe.13050 pubmed: 30675733
Ritto FG, Pimentel T, Canellas JVS, Junger B, Cruz M, Medeiros PJ. Randomized double-blind clinical trial evaluation of bone healing after third molar surgery with the use of leukocyte- and platelet-rich fibrin. Int J Oral Maxillofac Surg. 2019;48:1088–93.
doi: 10.1016/j.ijom.2019.01.020 pubmed: 30910410
Wushou A, Zheng Y, Han Y, Yang Z-C, Han F-K. The use of autogenous tooth bone graft powder in the treatment of osseous defects after impacted mandibular third molar extraction: a prospective split-mouth clinical pilot study. BMC Oral Health. 2022;22:433.
doi: 10.1186/s12903-022-02473-y pubmed: 36184595 pmcid: 9526982
Huchim-Chablé M, de Arredondo RS-M, Rivero-Navarrete JA, Mendiburu-Zavala C, Cárdenas-Erosa R, Peñaloza-Cuevas R. Calcium sulfate and plasma Rich in Growth factors enhance bone regeneration after extraction of the Mandibular Third Molar: a proof of Concept Study. Mater (Basel). 2021;14:1126.
doi: 10.3390/ma14051126
Yamalik K, Bozkaya S. The predictivity of mandibular third molar position as a risk indicator for pericoronitis. Clin Oral Investig. 2008;12:9–14.
doi: 10.1007/s00784-007-0131-2 pubmed: 17619915
Nunn ME, Fish MD, Garcia RI, Kaye EK, Figueroa R, Gohel A, et al. Retained asymptomatic third molars and risk for second molar pathology. J Dent Res. 2013;92:1095–9.
doi: 10.1177/0022034513509281 pubmed: 24132082 pmcid: 3834658
Throndson RR, Sexton SB. Grafting mandibular third molar extraction sites: a comparison of bioactive glass to a nongrafted site. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94:413–9.
doi: 10.1067/moe.2002.127582 pubmed: 12374912
Abdo VL, Suarez LJ, de Paula LG, Costa RC, Shibli J, Feres M, et al. Underestimated microbial infection of resorbable membranes on guided regeneration. Colloids Surf B Biointerfaces. 2023;226:113318.
doi: 10.1016/j.colsurfb.2023.113318 pubmed: 37075523
Kao RT, Nares S, Reynolds MA. Periodontal regeneration - intrabony defects: a systematic review from the AAP Regeneration Workshop. J Periodontol. 2015;86(2 Suppl):S77–104.
pubmed: 25216204
Yang Y, Tian Y, Li-juan S, Hong-lei Q, Zhi-bang L, Bei-min T et al. The impact of anatomic features of asymptomatic third molars on the pathologies of adjacent second molars: a cross-sectional analysis. Int Dent J. 2023;73.
Al Qabbani A, Al Kawas S, A Razak NH, Al Bayatti SW, Enezei HH, Samsudin AR, et al. Three-Dimensional Radiological Assessment of alveolar bone volume preservation using bovine bone xenograft. J Craniofac Surg. 2018;29:e203–9.
doi: 10.1097/SCS.0000000000004263 pubmed: 29303859
Enezzi HH, Kjalil AA, Naif TN. A clinical analysis of surgically managed Mandibular fractures: Epidemiology, Clinical Profile, patterns, treatments, and outcomes. Int Med J. 2020;27:1–4.
Aldelaimi TN, Khalil AA. Surgical management of pediatric mandibular trauma. J Craniofac Surg. 2013;24:785–7.
doi: 10.1097/SCS.0b013e31828b6c47 pubmed: 23714880
Mariano S, David H, Moritz K, Iain C, Søren J, Tord B et al. Treatment of stage I-III periodontitis-the EFP S3 level clinical practice guideline. J Clin Periodontol. 2020;47 Suppl 22 Suppl 22.
Vivien K, Jack GC. Commentary: prognosis revisited: a system for assigning periodontal prognosis. J Periodontol. 2007;78.
Pier Carmine P, Carlo L, Guido P, Giuseppe D, Raffaella D, Fernando V et al. Influence of mandibular third molar surgical extraction on the periodontal status of adjacent second molars. J Periodontol. 2019;90.
Goldman HM, Cohen DW. The Infrabony Pocket: classification and treatment. J Periodontology. 1958;29:272–91.
doi: 10.1902/jop.1958.29.4.272
Brently AG, Matt JH, Michael PM, James TM, Pirkka VN, Brian LM. Comparison of clinical, periapical radiograph, and cone-beam volume tomography measurement techniques for assessing bone level changes following regenerative periodontal therapy. J Periodontol. 2009;80.
Jing G, Chi Y, Jiawei Z, Yingkai H. Autogenous bone grafting for treatment of osseous defect after impacted mandibular third molar extraction: a randomized controlled trial. Clin Implant Dent Relat Res. 2017;19.
Masumoto T, Hayashi I, Kawamura A, Tanaka K, Kasai K. Relationships among facial type, buccolingual molar inclination, and cortical bone thickness of the mandible. Eur J Orthod. 2001;23:15–23.
doi: 10.1093/ejo/23.1.15 pubmed: 11296507
Anne CT, Ralph Kent J, Thoma Van D, Steven TS, Lora AM. Clinical and other risk indicators for early periodontitis in adults. J Periodontol. 2005;76.
Karapataki S, Hugoson A, Falk H, Laurell L, Kugelberg CF. Healing following GTR treatment of intrabony defects distal to mandibular 2nd molars using resorbable and non-resorbable barriers. J Clin Periodontol. 2000;27.
Gilberto S, Mariano T, Tommaso B, Hom-Lay W. Prevention of mandibular third molar extraction-associated periodontal defects: a comparative study. J Periodontol. 2009;80.
Pierpaolo Cortellini C, Jacopo B, Giovanpaolo PP, Maurizio ST. Periodontal regeneration compared with access flap surgery in human intra-bony defects 20-year follow-up of a randomized clinical trial: tooth retention, periodontitis recurrence and costs. J Clin Periodontol. 2017;44.
Górski B, Jalowski S, Górska R, Zaremba M. Treatment of intrabony defects with modified perforated membranes in aggressive periodontitis: a 4-year follow-up of a randomized controlled trial. Clin Oral Investig. 2020;24:1183–96.
doi: 10.1007/s00784-019-02982-1 pubmed: 31324986
Mikami R, Mizutani K, Shioyama H, Matsuura T, Aoyama N, Suda T, et al. Influence of aging on periodontal regenerative therapy using enamel matrix derivative: a 3-year prospective cohort study. J Clin Periodontol. 2022;49:123–33.
doi: 10.1111/jcpe.13552 pubmed: 34545600
Mikami R, Sudo T, Fukuba S, Takeda K, Matsuura T, Kariya T, et al. Prognostic factors affecting periodontal regenerative therapy using recombinant human fibroblast growth factor-2: a 3-year cohort study. Regen Ther. 2022;21:271–6.
doi: 10.1016/j.reth.2022.07.006 pubmed: 36092500 pmcid: 9440263
Eickholz P, Röllke L, Schacher B, Wohlfeil M, Dannewitz B, Kaltschmitt J, et al. Enamel matrix derivative in propylene glycol alginate for treatment of infrabony defects with or without systemic doxycycline: 12- and 24-month results. J Periodontol. 2014;85:669–75.
doi: 10.1902/jop.2013.130290 pubmed: 24059744
L N DS, C A, G P, Gh L. M T. Periodontal infrabony defects: systematic review of healing by defect morphology following regenerative surgery. J Clin Periodontol. 2021;48.
Aoki H, Bizenjima T, Seshima F, Sato M, Irokawa D, Yoshikawa K, et al. Periodontal surgery using rhFGF-2 with deproteinized bovine bone mineral or rhFGF-2 alone: 2-year follow-up of a randomized controlled trial. J Clin Periodontol. 2021;48:91–9.
doi: 10.1111/jcpe.13385 pubmed: 33030228
Andrea R, Johanna E, Siro Pietro DR, Jean-Claude I, Anton S, Giovanni Edoardo S. Radiographic angle width as predictor of clinical outcomes following regenerative periodontal therapy with enamel matrix derivative: a retrospective cohort study with a mean follow-up of at least 10 years. Quintessence international (Berlin, Germany: 1985). 2023;54.
Joni Augusto C, Tiago F, Carlos Heitor Cunha M, Rafael Scaf M, Tamires D, Enílson Antonio S. Periodontal regeneration: is it still a goal in clinical periodontology? Brazilian oral Res. 2021;35 Supp 2.
Hyo-Sang P, Youn-Ju L, Seong-Hwa J, Tae-Geon K. Density of the alveolar and basal bones of the maxilla and the mandible. American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies. Volume 133. and the American Board of Orthodontics; 2008.
Kugelberg CF. Periodontal healing two and four years after impacted lower third molar surgery. A comparative retrospective study. Int J Oral Maxillofac Surg. 1990;19.
Thomas BD. Is there a role for reconstructive techniques to prevent periodontal defects after third molar surgery? Oral Maxillofac Surg Clin N Am. 2007;19.

Auteurs

Si-Min Tang (SM)

College of Dentistry, Zhejiang Chinese Medical University, Hangzhou, China.

Di-Xin Liu (DX)

Department of Periodontology, Hangzhou Stomatology Hospital, 1 Pinghai Road, Hangzhou, Zhejiang Province, China.

Zi-Yun Xiong (ZY)

Department of Periodontology, Hangzhou Stomatology Hospital, 1 Pinghai Road, Hangzhou, Zhejiang Province, China.

Yi-Qian Shao (YQ)

College of Dentistry, Zhejiang Chinese Medical University, Hangzhou, China.

Jing Jiang (J)

College of Dentistry, Zhejiang Chinese Medical University, Hangzhou, China.

Li Chen (L)

College of Dentistry, Zhejiang Chinese Medical University, Hangzhou, China.

Qin Xiong (Q)

College of Dentistry, Zhejiang Chinese Medical University, Hangzhou, China.

Shuo-Yan Wu (SY)

College of Dentistry, Zhejiang Chinese Medical University, Hangzhou, China.

Dong-Ying Xuan (DY)

Department of Periodontology, Hangzhou Stomatology Hospital, 1 Pinghai Road, Hangzhou, Zhejiang Province, China. xuanxuan187@126.com.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH