Effect of Surgical Intervention for Removal of Mandibular Third Molar on Periodontal Healing of Adjacent Mandibular Second Molar: A Systematic Review and Bayesian Network Meta‐Analysis

Abstract

To the best of the authors' knowledge, the present review is the first one to evaluate quantitatively and qualitatively the effect of different interventions on periodontal healing distal to the second molar after extraction of the third molar. GTR-based procedures with or without combined grafting therapies provide some adjunctive clinical benefit compared to standard non-regenerative/non-grafting procedures. However, the overall low quality of evidence suggests a low degree of confidence and certainty in treatment effects. Evidence on variations of surgical M3M removal techniques based on flap design, type of suturing, and periodontal care of M2M is limited both qualitatively and quantitatively.

Influence of mandibular third molar surgical extraction on the periodontal status of adjacent second molars

“…Scientific evidence on M3 surgical extraction techniques, flap design, suturing, and M2 periodontal care, is limited both qualitatively and quantitatively. 35 Patients with history of periodontitis seem to have deeper baseline distal M2 pockets (6.2 mm) than those without (4.9 mm), and therefore, emphasis in thorough mechanical debridement may be a key factor in soft tissue healing. At 6 months recall the mean PPD changed to 4.3 mm (history of periodontitis group) and 2.3 mm (no history of periodontitis group), with higher probing readings for those with history of periodontitis.…”

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

“…Similarly, little or no benefit was found with different flap designs used in these situations . Guided tissue regeneration (GTR)‐based procedures with or without bone grafting therapies provide some adjunctive clinical benefit compared to standard non‐grafting procedures . Augmentation of the osseous defect with bone grafts has become one of the most common surgical techniques in recent years.…”

“…7 Guided tissue regeneration (GTR)-based procedures with or without bone grafting therapies provide some adjunctive clinical benefit compared to standard non-grafting procedures. 8 Augmentation of the osseous defect with bone grafts has become one of the most common surgical techniques in recent years. Various bone-grafting materials have been used in postextraction site, include autogenous bone (harvested from the mandible during the rotatory osteotomy), 9 allogenic bone, [10][11][12] platelet rich plasma, 9,13 platelet-rich fibrin, 14 synthetic bone graft substitutes (eg, Bio-oss, 15,16 bioactive glass, 17 and synthetic calcium hydroxyapatite 9 ) and a combination of these materials.…”

Clinical Study for Silk Mat Application into Extraction Socket: A Split-Mouth, Randomized Clinical Trial

“…To prevent postoperative periodontal pathology, flap design, suture technique, and periodontal care for the second molar were considered, but there is controversy about their effect on prevention [16]. GBR with a collagen membrane or PTFE membrane is a reliable method and beneficial in reducing PD compared with a non-regenerative/non-graft procedure [35]. There was no significant difference in PD reduction between the collagen membrane group and the PTFE membrane group after mandibular third-molar extraction [19].…”

“…The reduction in PD for the non-regenerative/non-graft procedure group was 1.3 mm at three months [14] and 1.93 mm at 12 months [5]. When the PTFE group was compared with the non-regenerative/non-graft procedure group, a significant benefit from the PTFE membrane was demonstrated after mandibular third-molar extraction [20,35]. In cases of collagen membrane application, the amount of PD reduction at one year after extraction was 5.3 ± 1.9 mm [19].…”