ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Local Periodontal Care Around Mandibular Second Molar After Third Molar Extraction Decreases Probing Depth Around Periodontally Involved Second Molars
Clinical Question In a patient with >5mm pocket depth adjacent to the mandibular second molar, does the risk of periodontal defects, such as loss of attachment level and increased probing depths, surrounding that molar decrease after performing ultrasonic root debridement to the area of the second molars after third molar removal versus only performing standard socket debridement?
Clinical Bottom Line For patients with pocket depths greater than 5mm adjacent to the second molar, ultrasonic root debridement following third molar extraction decreased probing depths more than standard socket debridement. This is supported by a single blinded randomized, control trial in which the results showed shallower probing depths after ultrasonic root debridement at a statistically significant difference.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 15966878Leung/200530 patients with impacted third molar and pocket depth > 5mm adjacent to second molar.Randomized Controlled Trial
Key resultsA randomized controlled trial of 30 subjects with an impacted mandibular third molar and >5mm probing pocket depth (PPD) adjacent to the second molar were investigated following third molar extraction and local periodontal care to the second molar. There were 14 subjects in the test group and 16 in the control group. The control group had third molar extraction followed by standard socket debridement whereas the test group had that treatment plus ultrasonic root debridement and a plaque control program. The test molars had PPD decrease to 3.2 +/- 1.2mm at 6 months post extraction and the control molars had PPD of 5.2 +/- 0.7mm. Thus the test group had statistically significant shallower probing depths (p<0.007).
Evidence Search ("Periodontal Pocket"[Mesh] AND "Molar, Third"[Mesh]) AND "Tooth Extraction"[Mesh]
Comments on
The Evidence
Validity: This study is based on a randomized controlled trial with a sample size of 30 patients who had no systemic diseases, no orthodontic treatment, and no areas of PPD >5mm except for the mandibular second molar involved site. The extractions were performed by dental surgeons stated to be unrelated to the study. All patients had a 6 month recall examination by an examiner who was blinded to the assigned groups. The potential for biased results seems to be unlikely.
Applicability The acquired information is applicable to patients who have periodontal pockets on the mandibular second molars and are undergoing third molar removal. It is also applicable to practitioners providing these procedures in order to develop treatment plans customized to patients with these periodontal conditions.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics)
Keywords Third molars, second molars, ultrasonic root debridement, extraction
ID# 2669
Date of submission: 03/12/2014spacer
E-mail patelh4@livemail.uthscsa.edu
Author Hiral Patel
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Archie Jones, DDS
Faculty mentor/Co-author e-mail JonesA@uthscsa.edu
Basic Science Rationale
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