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Journal of Maxillofacial & Oral Surgery logoLink to Journal of Maxillofacial & Oral Surgery
. 2009 Jun 10;8(1):22–26. doi: 10.1007/s12663-009-0006-y

Alveolar bone grafts distal to the lower second molar

P L G Coceancig 1,
PMCID: PMC3454012  PMID: 23139464

Abstract

Introduction

This paper presents case and technique reports on the use of Bio-Oss® and Bio-Gide® implantable material for the establishment of a mineral and protein scaffold for reconstruction of the distal alveolus of the lower distal second molar (lower dM2).

Methods

Such ‘alveolar bone grafts’ were undertaken immediately following the removal of deep horizontal or mesio-angular impacted wisdom teeth, and which had the following associations. 1) Partial eruption of the third molar, 2) Preoperative radiographic (OPG) evidence of loss of bone height (≥3mm) below the distal Cemento-Enamel Junction (CEJ) of the lower dM2, and 3) Patient aged ≥26 years of age. Following a presentation of radiographs (in three patients) taken preoperatively and postoperatively (at ∼6 months), a brief description of the technique is offered as well as a brief literature review on the subject.

Conclusion

The author suggests that for older patients (≥26 years) were there is the presence of partially exposed deep mesio-angular or horizontal impacted wisdom teeth, and which are associated with the radiographic appearance of bone loss to the distal surface of the lower second molar tooth, then alveolar bone grafting utilising Bio-Oss® and Bio-Gide® is an effective and stable treatment option to prevent development of periodontal pocketing in the area. The author advises for more guided and systematised study in this area.

Keywords: Alveolar bone graft, Bio-Oss®, Bio-Gide®, Lower dM2, Distal second molar

Full Text

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References

  • 1.Dodson T.B. Reconstruction of alveolar bone defects after extraction of mandibular third molars: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82(3):241–247. doi: 10.1016/S1079-2104(96)80346-5. [DOI] [PubMed] [Google Scholar]
  • 2.Dodson T.B. Management of mandibular third molar extraction sites to prevent periodontal defects. J Oral Maxillofac Surg. 2004;62(10):1213–1224. doi: 10.1016/j.joms.2004.06.035. [DOI] [PubMed] [Google Scholar]
  • 3.Peng K.Y., Tseng Y.C., Shen E.C., Chiu S.C., Fu E., Huang Y.W. Mandibular second molar periodontal status after third molar extraction. J Periodontol. 2001;72(12):1647–1651. doi: 10.1902/jop.2001.72.12.1647. [DOI] [PubMed] [Google Scholar]
  • 4.Kan K.W., Liu J.K., Lo E.C., Corbet E.F., Leung W.K. Residual periodontal defects distal to the mandibular second molar 6–36 months after impacted third molar extraction. J Clin Periodontol. 2002;29(11):1004–1011. doi: 10.1034/j.1600-051X.2002.291105.x. [DOI] [PubMed] [Google Scholar]
  • 5.Throndson R.R., Sexton S.B. Grafting mandibular third molar extraction sites: a comparison of bioactive glass to a non-grafted site. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(4):413–419. doi: 10.1067/moe.2002.127582. [DOI] [PubMed] [Google Scholar]
  • 6.Karapataki S., Hugoson A., Falk H., Laurell L., Kugelberg C.F. Healing following GTR treatment of intra-bony defects distal to mandibular 2nd molars using resorbable and non-resorbable barriers. J Clin Periodontol. 2000;27(5):333–340. doi: 10.1034/j.1600-051x.2000.027005333.x. [DOI] [PubMed] [Google Scholar]
  • 7.Kugelberg C.F., Ahlstrom U., Ericson S., Hugoson A. Periodontal healing after impacted lower third molar surgery. A retrospective study. Int J Oral Maxillofac Surg. 1985;14(1):29–40. doi: 10.1016/s0300-9785(85)80007-7. [DOI] [PubMed] [Google Scholar]
  • 8.Kugelberg C.F. Periodontal healing two and four years after impacted lower third molar surgery. A comparative retrospective study. Int J Oral Maxillofac Surg. 1990;19(6):341–345. doi: 10.1016/S0901-5027(05)80077-3. [DOI] [PubMed] [Google Scholar]
  • 9.Elter J.R., Cuomo C.J., Offenbacher S., White R.P., Jr Third molars associated with periodontal pathology in the Third National Health and Nutrition Examination Survey. J Oral Maxillofac Surg. 2004;62(4):440–445. doi: 10.1016/j.joms.2003.12.002. [DOI] [PubMed] [Google Scholar]
  • 10.Kugelberg C.F., Ahlstrom U., Ericson S., Hugoson A., Kvint S. Periodontal healing after impacted lower third molar surgery in adolescents and adults. A prospective study. Int J Oral Maxillofac Surg. 1991;20(1):18–24. doi: 10.1016/S0901-5027(05)80689-7. [DOI] [PubMed] [Google Scholar]
  • 11.Osborne W.H., Snyder A.J., Tempel T.R. Attachment levels and crevicular depths at the distal of mandibular second molars following removal of adjacent third molars. J Periodontol. 1982;53(2):93–95. doi: 10.1902/jop.1982.53.2.93. [DOI] [PubMed] [Google Scholar]
  • 12.Elter J.R., Offenbacher S., White R.P., Beck J.D. Third molars associated with periodontal pathology in older Americans. J Oral Maxillofac Surg. 2005;63(2):179–184. doi: 10.1016/j.joms.2004.10.004. [DOI] [PubMed] [Google Scholar]
  • 13.Dodson T.B. Is there a role for reconstructive techniques to prevent periodontal defects after third molar surgery? Oral Maxillofac Surg Clin North Am. 2007;19(1):99–104. doi: 10.1016/j.coms.2006.11.004. [DOI] [PubMed] [Google Scholar]
  • 14.Dodson T.B., Richardson D.T. Risk of periodontal defects after third molar surgery: An exercise in evidence based clinical decision making. Oral Maxillofac Surg Clin North Am. 2007;19(1):93–8. doi: 10.1016/j.coms.2006.11.003. [DOI] [PubMed] [Google Scholar]
  • 15.Marmary Y., Brayer L., Tzukert A., Feller L. Alveolar bone repair following extraction of impacted mandibular third molars. Oral Sug Oral med Oral Pathol. 1986;61(4):324–326. doi: 10.1016/0030-4220(86)90409-3. [DOI] [PubMed] [Google Scholar]
  • 16.Ash M.M., Jr, Costich E.R., Hayward J.R. A study of periodontal hazards of third molars. J Periodontol. 1962;33:209–219. [Google Scholar]
  • 17.Motamedi M.H. Preventing periodontal pocket formation after removal of an impacted mandibular third molar. J Am Dent Assoc. 1999;130(10):1482–1484. doi: 10.14219/jada.archive.1999.0060. [DOI] [PubMed] [Google Scholar]
  • 18.Kugelberg C.F. Impacted lower third molars and periodontal health. An epidemiological, methodological, retrospective and prospective clinical, study. Swed Dent J Suppl. 1990;68:1–52. [PubMed] [Google Scholar]
  • 19.Pecora G., Celleti R., Davapanah M. The effects of guided tissue regeneration on healing after impacted mandibular third molar surgery: 1-Year results. Int J Periodont Restor Dent. 1993;13:397. [Google Scholar]
  • 20.Oxford G.E., Quintero G., Stuller C.B., Gher M.E. Treatment of 3rd molar induced periodontal defects with guided tissue regeneration. J Clin Periodontol. 1997;24(7):464–469. doi: 10.1111/j.1600-051X.1997.tb00213.x. [DOI] [PubMed] [Google Scholar]
  • 21.Bio-Oss® and Bio-Gide® (2002) product guides. Osteohealth Company. 2002; April.

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