Prevention of Periodontal Pocket Formation after Mandibular Third Molar Extraction Using Dentin Autologous Graft: A Split Mouth Case Report

Abstract

Surgical extraction of the third molar can often result in the development of a periodontal pocket distal to the second molar that could delay the healing, and the socket could be colonized by bacteria and lead to secondary abscesses, or it may cause mobility or hypersensitivity. The aim of this case report is to assess the efficacy of a dentin autograft in the prevention of periodontal dehiscences after the surgical extraction of the third molar, obtained by the immediate grinding of the extracted tooth. A healthy 18-year-old male patient underwent surgery of both impacted mandibular molars: right postextractive socket was filled with grinded dentin; then, the left one was filled with fibrin sponge. The patient was followed up for six months, and clinical and radiographic assessment were performed: measurements of plaque index (PI), bleeding on probing (BOP), gingival index (GI), clinical attachment level (CAL), and probing pocket depth (PPD) were done before surgery and repeated at 90 and 180 days after the extractions. Measurements made at six months after the surgery revealed that the grafted site was characterized by a minor depth of the pocket if compared with the nongrafted site, with no clinical/radiographic signs of complications.

Autologous Dentin Graft after Impacted Mandibular Third Molar Extraction to Prevent Periodontal Pocket Formation—A Split-Mouth Pilot Study

“…who was not informed of the treatment undergone by the individual patients measured preoperative and postoperative bone level distal to M2 on periapical radiographs taken at different follow-up times by the software AutoCAD 2017 (Autodesk, San Rafael, CA, USA), then validated by Invivo software (Anatomage Inc., San Jose, CA, USA) and 3D Endo Software (Dentsply Sirona, Charlotte, NC, USA). The radiographic bone level was measured at T1 and T180 as the distance between the distal point of a line passing through the cemento-enamel junction of M2 (mesial and distal projection of M2's CEJ) and the bone peak distal to M2, at the bottom of the bony defect, as described in a previous study [35]. Bone gain (BG) was considered as the difference between bone level at T1 and T180.…”

A novel porcine dentin-derived bone graft material provides effective site stability for implant placement after tooth extraction: a randomized controlled clinical trial

“…Dentin is characterized by a regular arrangement of tubular pores with dimensions of 1–2 µm which is an ideal size for interaction with host tissue while bone generally has pores that are larger or smaller than this range. Autogenous tooth dentin has been successfully used as a bone graft material for dental procedures [ 9 – 17 , 51 , 52 ] confirming that dentin-based materials are suitable for grafting but having the disadvantage that there is often not enough material for the required procedure. Ivory Dentin Graft™ is processed at relatively low temperatures compared to materials such as Bio-Oss® and thus retains the protein content of the dentin (ca.…”

Risk factors of complications subsequent third molar extractions: A prospective cohort study

“…[24] Other complications that were mentioned by De Biase et al that were not assessed in this study included the development of a periodontal pocket distal to the second molar that could delay the healing, and the bacterial colonization at the extraction socket that might lead to secondary abscesses formation. [25] One of the drawbacks of the study is that there was potential observer bias with regards to reporting complications by the patients. For instance, pain, as a post-operative complication, was self-reported by the patient which left a wide margin for over/under estimation for reporting pain.…”