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Journal of Oral Science & Rehabilitation Issue 01/2015

Volume 1 | Issue 1/2015 53Journal of Oral Science & Rehabilitation Rem ova l of parti ally e ru pte d mandi bu lar thi rd mo lars extractionanddecreasestheriskofcomplications. The age of 25 appears to be critical, after which complicationsincreasemorerapidly.8 In a retrospective study of 215 patients, Kugelberg et al. found that two years after the surgical removal of impacted mandibular third molars, 43.3% of the cases exhibited a probing pocketdepth(PPD)of> 7 mmand32.1%showed intrabonydefects of> 4 mm distaltothe mandi- bular second molars.9 The postoperative plaque controlscoreindicatedthatinmostofthepartici- pantsthelevelofplaquecontrolatthedistalsur- face ofthe second molarwas not optimal. Leung et al. showed that a regime of strict plaque con- trol prevented residual pockets at periodontally involved second molars six months after the re- movalofthethirdmolar.10 Kanetal.investigated the periodontal condition distal to mandibular secondmolars6–36monthsafterroutinesurgi- cal extraction of adjacent impacted third molars in 158 subjects under 40 years of age.11 Three possible risk indicators were associated with lo- calized increased PPD atthe distalsurface ofthe mandibular second molar: third molar mesio- angular impaction; pre-extraction signs of bone loss; and inadequate post-extraction local plaquecontrol.11 The aim ofthe current studywas to evaluate the effect of supervised plaque control after the extraction of partially erupted mandibular third molars on the periodontal condition distal to the secondmolars. Materials&methods Patie n t rec ruitm en t Thesubjectsinvolvedinthisstudywereselected from consecutive patients referred to the de- partment of oral surgeryat SödraÄlvsborg Hos- pital (Borås, Sweden) for extraction of mandibu- lar third molars. The protocol of the study was approved bythe Central Ethical Review Board at the University of Gothenburg (Sweden). The pa- tients who met the inclusion criteria were in- formed about the diagnosis and treatment plan. They were also informed of the purpose of the studyandgavetheirconsentforparticipation. In order to be included in the study, the pa- tients had to be 18 years of age or older, have a partially erupted third molar in need of extrac- tion,presentwithbonelossdistaltotheadjacent secondmolarof> 2 mm(asmeasuredfromavail- able radiographs) and a PPD of ≥ 6 mm, but oth- erwisebehealthyfromaperiodontalperspective (i.e.,nobonelossof> 1 mmandnoPPDof≥ 5 mm at the residual dentition; Fig. 1a). Patients with medicalconditionsthat could compromise heal- ingattheextractionsitewereexcluded. Cli ni cal e xami nati o n The following clinicalvariables were recorded at the baseline examination by one examiner (ASP) atthedistalsurfaceofthesecondmolars: Plaque index (PI): The presence or absence of plaque was determined after staining with dis- closing solution (Rondell Blue, Nordenta, Enköping, Sweden) at the distal sites of the sec- ondmolars. Bleeding/suppuration on probing (BoP/Sup): The presence or absence of bleeding/suppura- tionupto15 safterprobingwasdetermined. PPD: Pocket depthwas measured in millimeters with a manual PCP-15 periodontal probe (Hu- Friedy, Leimen, Germany) to the nearest milli- meter at the distobuccal, distal and distolingual surfacesofthesecondmolars. Figs. 1a & b Partially erupted third molar in a patient without periodontal disease except distal to the second molar (a). The bone-level measurement before extraction of the third molar (b). Figs. 1a & b a b

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