Montero Javier, Mazzaglia Giuseppe
Department of Surgery, University of Salamanca, Salamanca, Spain.
J Oral Maxillofac Surg. 2011 Nov;69(11):2691-7. doi: 10.1016/j.joms.2011.06.205. Epub 2011 Aug 23.
The aim of this study was to evaluate the change in the periodontal status of mandibular second molars after surgical extraction of adjacent impacted lower third molars.
The study was based on a 1-year follow-up of 48 patients (20 men and 28 women) recruited consecutively after the extraction of an impacted lower third molar. Panoramic radiographs were obtained and clinical examinations were carried out at baseline to determine the periodontal status (probing depth and dental plaque and gingival indices) both for the second molar and for the 4 posterior sextants. After surgical removal of the impacted mandibular third molars, all patients were assessed at 3, 6, 9, and 12 months for changes in periodontal status.
The periodontal health of the second molar was found to improve gradually after third molar surgery in all clinical parameters. Probing depth was gradually reduced by about 0.6 mm quarterly, until a final depth of 2.6 ± 0.8 mm was attained. The relative risk of having a plaque index and gingival index coded as 0 (healthy) or 1 (minor problems) was about 10 times higher at the end of the follow-up than at baseline for both indices. The periodontal status of the 4 posterior sextants also improved gradually. Molar depth, according to the Pell and Gregory classes and types, seemed to be the main factor modulating both the baseline probing depth and the change in probing depth during follow-up.
Our results suggest that the initial periodontal breakdown established on the distal surfaces of the second molars and in the periodontal health of the 4 posterior sextants can be significantly improved 1 year after surgical removal of the ipsilateral lower third molar.
本研究旨在评估相邻下颌阻生第三磨牙手术拔除后下颌第二磨牙牙周状况的变化。
本研究基于对48例患者(20名男性和28名女性)进行的为期1年的随访,这些患者在拔除下颌阻生第三磨牙后连续入选。在基线时获取全景X线片并进行临床检查,以确定第二磨牙和4个后牙象限的牙周状况(探诊深度、牙菌斑和牙龈指数)。在手术拔除下颌阻生第三磨牙后,对所有患者在3、6、9和12个月时评估牙周状况的变化。
在所有临床参数方面,发现第三磨牙手术后第二磨牙的牙周健康状况逐渐改善。探诊深度每季度逐渐降低约0.6mm,直至最终深度达到2.6±0.8mm。在随访结束时,菌斑指数和牙龈指数编码为0(健康)或1(轻微问题)的相对风险比基线时高出约10倍。4个后牙象限的牙周状况也逐渐改善。根据佩尔和格雷戈里分类及类型,磨牙深度似乎是调节基线探诊深度和随访期间探诊深度变化的主要因素。
我们的结果表明,在同侧下颌第三磨牙手术拔除1年后,第二磨牙远中面初始建立的牙周破坏以及4个后牙象限的牙周健康状况可得到显著改善。