Autogenous bone grafting for treatment of osseous defect after impacted mandibular third molar extraction: A randomized controlled trial

Abstract

The result of this study demonstrated that scaling and root planning was beneficial to periodontal healing of M2 after impacted M3 extraction. Addition of autogenous bone grafting for the treatment of osseous defects distal to M2 was safe and more effective than periodontal treatment alone. (Registry Number: ChiCTR-IOC-15006561).

Comparison of different grafting materials for treatment of bone defect distal to the molar in canine

“…3 The parameters representing new bone formation were highest in group Ta, which in accordance with the results of several studies 9,15,16 and proved again that the AB is the gold standard of bone grafting material. Until 12 weeks after surgery, conspicuous invagination remained still.…”

“…It can be concluded that distal bone defect may lead to severe periodontal bone loss of the molar, and confirm the finding of our previous randomized controlled clinical study. 3 There is report in the literature that up to 65% resorption of the augmented AB in minipig maxillary sinus floor augmentation during the first 12 weeks. In group Ta, the sites displayed a normal morphology of bone and bone marrow, little AB particles could be identified, probably because of their rapid incorporation and subsequent resorption as part of the remodeling process.…”

“…The amount of AB is not sufficient to fill the bone defect completely, just like clinical situation. 3 Group Tb: DBBM (Bio-Oss, Geistlich Pharma, Wolhusen, Switzerland) with a resorbable porcine collagen membrane (CM; Bio-Gide, Geistlich Pharma, Wolhusen, Switzerland).…”

“…The phenomenon was also observed in our previous randomized controlled clinical study. 3 There is report in the literature that up to 65% resorption of the augmented AB in minipig maxillary sinus floor augmentation during the first 12 weeks. 17 However, in our study, reduction of bone volume was not observed in group Ta, the reason might be as follows: (1) period was relatively short so that the resorption did not occur; (4) the grafted AB was harvested from the extraction socket, which is membranous bone and beneficial for alveolar bone regeneration 28 ; (5) the grafted site (mandibular 2nd molar) was constantly subjected to functional loading that can reduce the resorption.…”

“…A randomized controlled clinical trial was conducted by our team, which confirmed that the extraction of impacted M3 may lead to distal bone defect of M2, and revealed that grafting autogenous bone (AB) (harvested during the M3 extraction surgery) is an effective and safe method to treat the distal osseous defect of M2. 3 However, after the extraction of deeply impacted M3 or M3 with follicle, the AB is often in shortage for grafting, and the resorption of autograft cannot be overlooked. Autogenous bone combined with xenografts could be an attempt to preserve or enhance grafting material volume.…”