Krausz A A, Machtei E E, Peled M
Department of Oral and Maxillofacial Surgery, Rambam Medical Center, Technion Faculty of Medicine, Haifa, Israel.
Int J Oral Maxillofac Surg. 2005 Oct;34(7):756-60. doi: 10.1016/j.ijom.2005.02.006.
Several conflicting findings have been published in previous literature regarding the effects of impacted third molar extraction on the periodontal health of the adjacent second molar; some authors have shown improvement of periodontal health distal to the adjacent second molar, whilst others have demonstrated loss of attachment and reduction of alveolar bone height. The purpose of this controlled clinical and radiographic study is to evaluate the long-term changes in periodontal health and alveolar bone height distal to the adjacent second molar following extraction of an impacted third molar. This split-mouth design study included 25 patients who underwent extraction of one mandibular impacted third molar (test), whereas the opposite tooth remained intact (control). Pre-operative and current-state panoramic radiographs were than scanned, and alveolar bone height was digitally measured on the distal aspect of the second molar on the test and control sides. Current-state clinical measurements were performed on both sides, and consisted of plaque index, gingival index, periodontal pocket depth, gingival margin position and clinical attachment level. Student's t-test for paired observations was used in order to examine the statistical significance of the differences in clinical parameters between the test and control sides and the differences in alveolar bone height pre- and post-operatively on both sides. Extraction of an impacted third molar resulted in a significant gain of alveolar bone height on the distal aspect of the adjacent second molar on the test side, whereas slight bone loss was noted on the control side. Even though the difference in plaque index between the test and control sides approached statistical significance following extraction, all clinical parameters seem to be unchanged. Further follow-up on clinical and radiological parameters is required for a more profound understanding of the long-term effects of third molar extraction on the periodontal health of the adjacent second molar.
先前的文献中发表了一些关于拔除阻生第三磨牙对相邻第二磨牙牙周健康影响的相互矛盾的研究结果；一些作者表明相邻第二磨牙远中侧的牙周健康有所改善，而另一些作者则证明出现了附着丧失和牙槽骨高度降低。这项对照临床和影像学研究的目的是评估拔除阻生第三磨牙后相邻第二磨牙远中侧牙周健康和牙槽骨高度的长期变化。这项采用分口设计的研究纳入了25例患者，这些患者拔除了一颗下颌阻生第三磨牙（试验组），而对侧牙齿保持完整（对照组）。然后扫描术前和当前状态的全景X线片，并在试验组和对照组第二磨牙远中侧数字测量牙槽骨高度。在两侧进行当前状态的临床测量，包括菌斑指数、牙龈指数、牙周袋深度、牙龈边缘位置和临床附着水平。使用配对观察的学生t检验来检验试验组和对照组之间临床参数差异以及两侧术前和术后牙槽骨高度差异的统计学意义。拔除阻生第三磨牙导致试验组相邻第二磨牙远中侧牙槽骨高度显著增加，而对照组出现轻微骨质流失。尽管拔除后试验组和对照组之间的菌斑指数差异接近统计学意义，但所有临床参数似乎均未改变。为了更深入地了解拔除第三磨牙对相邻第二磨牙牙周健康的长期影响，需要对临床和放射学参数进行进一步随访。
