Surgical Removal of the Fully Impacted Mandibular Third Molar: The Influence of Flap Design and Alveolar Bone Height on the Periodontal Status of the Second Molar

This study was carried out because a great deal of uncertainty exists as to he effect of the surgical removal of the fully impacted third molar on the periodontal status of the second molar. The objectives were to determine the effect of surgical removal of the third molar on the periodontal status of the second molar; the influence of flap design on these results; the influence of the initial height of the alveolar bone on the distal of the second molar on subsequent changes in attachment level. The study included 30 patients with bilateral mandibular impactions. A split-mouth experimental design was used, with one side of the mandible being randomly allocated to one of two flap design groups. Plaque level, gingival inflammation, probing depth and attachment level measurements around the second molar were taken at baseline and then at monthly intervals for a period of 6 months. Alveolar bone height was measured from panoramic radiographs. Six months postsurgically, both flap design groups exhibited a statistically significant loss of attachment level on the distal surface of the second molar with no difference between the two flap groups. The initial height of the alveolar bone on the distal of the second molar had no influence on the loss of attachment. It was concluded that the surgical removal of the fully impacted mandibular third molar led to the loss of attachment on the distal of the second molar; flap design had no influence on the degree of attachment loss; the initial height of the alveolar bone on the distal of the second molar had no influence on the loss of attachment.