Management of Periodontal Defect after Mandibular Third Molar Extraction
International Journal of Clinical Oral and Maxillofacial Surgery
Volume 1, Issue 1, June 2015, Pages: 4-10
Received: Jun. 17, 2015; Accepted: Jun. 30, 2015; Published: Jul. 1, 2015
Views 4492      Downloads 126
Shadia Abdel-Hameed Elsayed, Lecturer of Oral & Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al Azhar University, Nasr City, Cairo, Egypt
Abeer Saad Gawish, Vise Dean and Professor of Oral Medicine and Periodontology, Faculty of Dentistry, Sinai University and Al-Azhar University, Cairo, Egypt
Amany Khalifa, Lecturer of Oral and Maxillofacial Surgery Department, Faculty of Oral and Dental Medicine, Elnahda University, Banisweef, Egypt
Article Tools
Follow on us
Objectives: 1) to compare the regeneration with and without applying nanohydroxyapetite (nHA) bone graft and to determine if there is a clinical potential benefits of nHA in the regeneration on postextraction alveolar bone healing of distal bone defects of mandibular 2nd molar, 2) to determine whether there are differences in postoperative clinical symptoms between the two groups. Study Design: a prospective, randomized controlled and double blinded study. The hypothesis is based on the extraction of impacted third molar in both groups by the same surgeon. A total of 50 patients were included in the present study, they were divided into two equal group. Group I treated by surgical extraction of impacted third molar with nHA on the socket, while Group II treated by surgical extraction of impacted third molar alone. Assessment of postoperative clinical symptoms (pain, swelling, trismus, infection), changes in probing depth and alveolar bone height and density at the distal second molar was done in both groups. Results: The highest acceleration in alveolar bone formation on the distal aspect of the adjacent second molar was observed on graft group. There were no statistically significant differences between groups regarding the clinical symptoms pain, swelling, trismus and infection. There was a significant reduction in probing pocket depth and increase in bone height and density at the end of study period in both groups. Conclusions: According to the results of the present study, the use of nanohydroxyapetite bone graft show improvement on height and density of alveolar bone and there was a significant reduction of the probing pocket depth. The clinical symptoms seems similar with non- significant differences between groups regarding pain, swelling, trismus and infection.
Periodontal Defect, Mandibular Third Molar Extraction, Bone Graft, Nanohydroxyapetite
To cite this article
Shadia Abdel-Hameed Elsayed, Abeer Saad Gawish, Amany Khalifa, Management of Periodontal Defect after Mandibular Third Molar Extraction, International Journal of Clinical Oral and Maxillofacial Surgery. Vol. 1, No. 1, 2015, pp. 4-10. doi: 10.11648/j.ijcoms.20150101.12
Sammartino G, Tia M,Gentile E, Marenzi G, Claudio PP. Platelet rich plasma and resorbable membrane for prevention of periodontal defects after deeply impacted lower third molar extraction. J Oral Maxillofac Surg 2009; 67:2369-2373.
Pilloni A, Saccucci M, Di Carlo G, Zeza B, Ambrosca M, Paolantonio , Sammartino G, Mongardini C, Polimeni A. Clinical evaluation of the regenerative potential of MD and NanoHA in periodontal infrabony defects: a 2-year follow-up. Biomed Res Int 2014;492725, 2014.
Kandasamy S, Jerrold L, Friedman JW. Asymptomatic third molar extractions: Evidence-based informed consent Journal of the World Federation of Orthodontists, 2012; 1: 135-138.
Esposito M and Coulthard P. Impacted wisdom. Clin Evid 2008;23: 1302-1307.
Dodson TB: Management of mandibular third molar extraction sites to prevent periodontal defects. J Oral Maxillofac Surg 2004; 62:1213-1214.
Throndson RR, Sexton SB. Grafting mandibular third molar extraction sites: a comparison of bioacytive glass to a non grafted site. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002; 94:413,
Reynolds MA, Aichelmann-Reidy ME, Branch-Mays GL. Regeneration of periodontal tissue: bone replacement grafts. Dent Clin North Am 2010;54:55–71.
Checchi V, Savarino L, Montevecchi M, Felice P , Checchi L. Clinical radiographic and histological evaluation of two hydroxyapatites in human extraction sockets: a pilot study. Int J Oral Maxillofac Surg 2011;40: 526–532.
Thorwarth M, Schultze-Mosgau S, Kessler P, Wiltfang J, Schlegel KA. Bone regeneration in osseous defects using a resorbable nanoparticular hydroxyapatite. J Oral Maxillofac Surg 2005; 63: 1626–1633.
Albrektsson T, Johansson C. Osteoinduction, osteoconduction and osseoinegration. Eur Spine J 2001; 10:96–101.
Striezel FP, Reichart PA, Graf HL. Lateral alveolar ridge augmentation using a synthetic nano-crystalline hydroxyapatite bon substitution material (Ostim1). Clin Oral Implant Res 2007; 18: 743–751.
Rothamel D, Schwarz F, Herten M, Engelhardt E, Donath K, Kuehn P, Becker J. Dimensional ridge alterations following socket preservation using a nanocrystalline hydroxyapatite paste. A histomorphometrical study in dogs. Int J Oral Maxillofac Surg 2008; 37: 741–747.
Schwarz F, Bieling K, Latz T, Nuesry E, Becker J. Healing of infrabony peri-implantitis defects following application of a nanocrystalline hydroxyapatite (Ostim1) or a bovine-derived xenograft (Bio-Oss1) in combination with a collagen membrane (Bio-GideTM). A case series. J Clin Periodontol 2006; 33: 491–499.
Schwarz F, Sculean A, Bieling K, Ferrari D, Rothamel D, Becker J. Two-year clinical results following treatment of peri-implantitis lesions using a nanocrystalline hydroxyapatite or a natural bone mineral in combination with a collagen membrane. J Clin Periodontol 2008; 35: 80–87.
Chris Arts JJ, Verdonschot N, Schreurs BW, Buma P. The use of a bioresorbable nano-crystalline hydroxyapatite paste in acetabular bone impaction grafting. Biomaterial 2006; 27: 1110– 1118.
Bouyer E, Gitzhofer F, Boulos MI: Morphological study of hydroxyapatite nanocrystals suspension. J Mater Sci Mater Med 2000; 11:523–531.
Kasaj A, Willershausen B, Reichert C, Rohrig B, Smeets R, Schmidt M. Ability of nanocrystallinic hydroxyapatite paste to promote human periodontal ligament cell proliferation. J Oral Sci 2008;50: 279–285.
Kasaj A, Rohrig B, Zafiropoulos GG, Willershausen B. Clinical evaluation of nanocrystalline hydroxyapatite paste in the treatment of human periodontal bony defects. A randomized controlled clinical trial: 6 month results. J Periodontol 2008;79: 394–400.
Ngiam M, Nguyen LT, Liao S, Chan CK, Ramakrishna S. Biomimetic nanostructured materials — potential regulators for osteogenesis? Ann Acad Med Singapore 2011;40:213–222.
Webster TJ, Ergun C, Doremus RH, Siegel RW, Bizios R. Enhanced functions of osteoblasto on nanophase ceramics. Biomaterials 2000; 21: 1803–1810.
Zhou H, Lee J. Nanoscale hydroxyapatite particles for bone tissue engineering. Acta Biomater 2011; 7:2769–2781.
Li Z, Yubao L, Aiping Y. Preparation and in vitro investigation of chitosan/nanohydroxyapatite composite used as bone substitute materials. J Mater Sci Mater Med 2005;16:213–219
Mcgrath C, Comfort B, Lo C and Luo Y. Changes in life quality following third molar surgery, the immediate postoperative period. Bri Dent J 2003;194: 265-268.
Sammartino G; Tia M; Gentile E; Marenzi G; Claudio PP. Use of autologous platelet rich plasma in periodontal defect treatment after extraction of impacted mandibular third molars. J Oral Maxillofac Surg 2005; 63:766.
Karring TH. Concepts in Periodontal Tissue Regeneration. In Clinical Periodontology and Implant Dentistry. 5th edition. Edited by Lindhe J. New York: Wiley Blackwell 2008;548–556.
Krausz AA, Machtei EE, Peled M. Effects of lower third molar extraction on attachment level and alveolar bone height of the adjacent second molar. Int J Oral Maxillofac Surg 2005; 34: 756-60.
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: 341–5.
Eshghpour M, Akbar RS and Nejat AH. Periodontal problems following surgical extraction of impacted mandibular third molar teeth. J of Dental Materials and techniques 2013;2:59-62.
Peng KY, Tseng YC, Shen EC, Chiu SC, Fu E, Huang YW . Mandibular second molar periodontal status after third molar extraction. J Periodontol 2001; 72: 1647-51.
Richardson DT, Dodson TB. Risk of periodontal defects after third molar surgery: An exercise in evidence-based clinical decision making.Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100: 133-7.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186