Faria Ana Inocêncio, Gallas-Torreira Mercedes, López-Ratón Mónica
Department of Stomatology, Faculty of Medicine and Dentistry, University of Santiago de Compostela, A Coruña, Spain.
J Oral Maxillofac Surg. 2012 Dec;70(12):2732-41. doi: 10.1016/j.joms.2012.07.044. Epub 2012 Sep 16.
To estimate the prevalence of preoperative periodontal defects and analyze 12-month spontaneous healing on the distal aspect of the mandibular second molar (M2) after impacted mandibular third molar (M3) extraction.
This prospective clinical study was conducted in 25 healthy young patients (21.03 ± 4.38 yr old) with 40 extractions of higher-risk periodontal impacted M3s. Plaque and gingival indexes, recession, bleeding on probing, probing depth (PD), and attachment level were recorded before surgery and at 3, 6, and 12 months after surgery at 5 sites on the distal aspect of the M2.
The initial mean PD was 5.70 ± 3.80 mm, with the deepest mean PD at the lingual side. At 12 months, a mean PD average of 3.77 ± 2.86 mm was recorded, with a total average recovery of 1.93 ± 2.46 mm (P < .001), that was higher at 3 months (-1.62 mm, P < .001). The PD and attachment level improvements were statistically significant (P < .001) and nearly clinically significant from baseline to 12-month follow-up and from the buccal to the lingual side of the distal aspect of the M2.
Impacted M3s adjacent to M2s lead to periodontal defects that are deepest at the lingual side and almost recover at 12 months after extraction. The first 3 months is considered the cutoff for periodontal healing. Young adults with high-risk periodontal M3 impactions may benefit from early extraction, which increases spontaneous periodontal healing.
评估术前牙周缺损的患病率,并分析下颌阻生第三磨牙(M3)拔除后下颌第二磨牙(M2)远中面12个月的自然愈合情况。
本前瞻性临床研究纳入了25例健康年轻患者(21.03±4.38岁),共拔除40颗具有较高牙周风险的阻生M3。在手术前以及术后3、6和12个月,记录M2远中面5个位点的菌斑指数、牙龈指数、牙龈退缩、探诊出血、探诊深度(PD)和附着水平。
初始平均PD为5.70±3.80mm,舌侧平均PD最深。12个月时,记录的平均PD为3.77±2.86mm,平均总恢复量为1.93±2.46mm(P<.001),3个月时恢复量更高(-1.62mm,P<.001)。从基线到12个月随访以及从M2远中面的颊侧到舌侧,PD和附着水平的改善具有统计学意义(P<.001)且几乎具有临床意义。
与M2相邻的阻生M3会导致牙周缺损,舌侧缺损最深,拔牙后12个月几乎恢复。前3个月被认为是牙周愈合的关键时期。患有高风险牙周M3阻生的年轻成年人可能受益于早期拔除,这会增加牙周自然愈合。