Petsos Hari, Korte Jörg, Eickholz Peter, Hoffmann Thomas, Borchard Raphael
Department of Periodontology, Centre for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany.
Private Practice, Soest, Germany.
J Clin Periodontol. 2016 May;43(5):453-60. doi: 10.1111/jcpe.12527. Epub 2016 Apr 18.
The aim of this study was to investigate the effect of mandibular third-molar (M3) removal on periodontal health of adjacent second molars (M2). Probing pocket depths (PPD) and probing attachment levels (PAL) have been described for primary outcome. As cofactors involved, gender, complications, two suture materials and two types of impaction were chosen as secondary outcomes.
Seventy-eight patients (49 female; mean age: 16.0 ± 2.0 years) with 78 asymptomatic impacted mandibular M3 were included in this study. Plaque and gingival indices, PPD and PAL were recorded prior and 6 months after surgery. Impacted teeth were classified as either fully impacted (completely within in the bone) or submucosal (fully covered by oral mucosa).
Average baseline PPD was reduced from 3.3 mm to 2.6 mm after 6 months (p < 0.05). Average PAL was reduced from 3.0 to 2.5 mm (p < 0.05). Preoperative PPD ≥ 4 mm at the distolingual and distobuccal sites was positively correlated with clinical improvement (PPD: p < 0.05; PAL: p < 0.05). The impaction class was also identified as positive cofactor for PPD (p = 0.039), but not for PAL.
Young patients may benefit from an early removal of mandibular M3, especially in the presence of certain cofactors.
本研究旨在调查拔除下颌第三磨牙(M3)对相邻第二磨牙(M2)牙周健康的影响。将探诊深度(PPD)和探诊附着水平(PAL)作为主要观察指标。作为相关辅助因素,选择性别、并发症、两种缝合材料和两种阻生类型作为次要观察指标。
本研究纳入78例患者(49例女性;平均年龄:16.0±2.0岁),均有78颗无症状的下颌阻生M3。在手术前及术后6个月记录菌斑指数、牙龈指数、PPD和PAL。阻生牙分为完全阻生(完全位于骨内)或黏膜下阻生(完全被口腔黏膜覆盖)。
6个月后,平均基线PPD从3.3mm降至2.6mm(p<0.05)。平均PAL从3.0降至2.5mm(p<0.05)。术前远中舌侧和远中颊侧部位PPD≥4mm与临床改善呈正相关(PPD:p<0.05;PAL:p<0.05)。阻生类型也被确定为PPD的正向辅助因素(p=0.039),但不是PAL的正向辅助因素。
年轻患者早期拔除下颌M3可能有益,尤其是在存在某些辅助因素的情况下。