Natural course following extraction of impacted mandibular third molars and their effect on mandibular second molars

doi:10.19438/j.cjoms.2024.04.008

Abstract

Abstract: PURPOSE: To observe the natural course after extraction of impacted mandibular third molars(IM3Ms) and their influence on adjacent mandibular second molars (M2Ms). METHODS: Thirty-four patients (51 IM3Ms) with bone impaction of mandibular third molars were selected. The affected teeth were extracted by piezosurgery and pneumatic turbine handpiece. The postoperative reaction and distal bone defect of M2Ms were observed before operation, 1 week and 6 months after operation. The depth of distal bone defect at M2Ms before and after operation was compared, and the influencing factors were analyzed. SPSS 29.0 software package was used for data analysis. RESULTS: Before surgery, no apparent bone defects were observed in the distal mesial bone of M2Ms, but bone defects occurred during IM3Ms extraction due to bone removal and tooth extraction procedures. After 6 months, although some recovery in bone height was observed and the rate of bone defects decreased, it did not reach the preoperative level. The depth of IM3Ms impaction was the main influencing factor for the recovery rate. Probing depth significantly increased compared to preoperative levels. Patients experienced more pain within 24 hours postoperatively, which eased after 1 week, although mild limitation of mouth opening and facial swelling persisted. The extraction of IM3Ms had minimal impact on patients' daily life, emotions, work, and sleep. CONCLUSIONS: After the mandibular third molar extraction, the distal bone height adjacent to the second molar will partially recover, but it doesn't reach the preoperative level. In order to reduce the impact on adjacent teeth and bone tissue, surgeons need to adopt more refined surgical techniques during tooth extraction. At the same time, analgesic drugs should be given after removal of IM3Ms, and health education should be strengthened to improve the comfort of patients.

Key words: Mandibular third molars, Mandibular second molars, Impact teeth extraction, Bone defects, Natural course

CLC Number:

R782.1

YANG Qing-ran, XU Guang-zhou. Natural course following extraction of impacted mandibular third molars and their effect on mandibular second molars[J]. China Journal of Oral and Maxillofacial Surgery, 2024, 22(4): 365-372.

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