Changes in Pocket Depth, Clinical Attachment Level , and Alveolar Bone Height Distal to Lower Second Molar After Impacted Lower Third Molar Removal

Shehab A. Hamad, Khadija M. Ali, Othman A. Omer


The purpose of this retrospective clinical and radiographic study was to evaluate the periodontal condition of mandibular second molar after surgical removal of adjacent impacted mandibular third molars in patients who had undergone a unilateral, partially or fully impacted third molar extraction, at the Outpatient Clinic, Department of Oral and Maxillofacial Surgery, College of dentistry, Hawler Medical University, between the years 2010 and 2011.The sample size was 40 healthy patient with inclusion criteria aged between 18-32 years old.

The same operator removed the impacted third molars in all patients. Periodontal measurements including periodontal probing depth PPD, clinical attachment level CAL,& alveolar bone height ABH were examined at distal surface of second molars before & 6 months after surgical removal of impacted mandibular third molars .OPG was taken for each patients pre& post operatively. The data were analyzed using SPSS soft ware, version 12(SPSS,Chicago,IL).A paired t- test was used to fined a significant changes in the three recorded variables about 6 months post operatively. The results from this study showed that a significant improvements in all the periodontal parameters after removal of impacted mandibular third molars.

Full Text:



Leung WK, Corbet EF, Kan KW, et al : A regimen of systematic periodontal care after removal of impacted mandibular third molars manages periodontal pockets associated with the Mandibular second molars. J Clin- Periodontol 2005; 32:725-731.

Hattab FN, Alhaija ES: Radiographic evaluation of Mandibular third molar eruption space. Oral Surg Oral Med Oral PatholOral RadiolEndod1999; 88:285.

García RI, Chauncey HH: The eruption of third molars in adults: A 10-year longitudinal study. Oral Surg Oral Med Oral Pathol1989; 68:9-13.

Hattab FN: Positional changes and eruption of impacted Mandibular third molars in young adults. A radio- graphic 4-yearfollow-up study.Oral Surg Oral Med Oral Pathol Oral RadiolEndod1997; 84:604-608.

Worrall SF, Riden K, Haskell R, et al : UK National Third Molar project: The initial report. Br J Oral Maxil- lofac Surg1998; 36:14-18.

Nordenram A, Hultin M, Kjellman O, et al : Indications for surgical removal of the mandibular third molar. Study of 2,630cases.Swed Dent J1987; 11:23-9.

Laskin D. Indication and contraindication for removal of impacted thirdmolars. Dent Clin North Am 1969: 13: 919–928

Peterson LJ. Rationale for removing impacted teeth: when to extract or not to extract. J Am Dent Assoc 1992: 123: 198–204

Dodson TB: Management of mandibular third molar extraction sites to prevent periodontal defects. J Oral MaxillofacSurg2004; 62:1213-24.

Peng KY, Tseng YC, Shen EC, et al : Mandibular second molar periodontal status after third molar extrac tion. J Periodontol2001;72:1647.

Blakey GH, Golden BA, White RP, et al .changes over time in the periodontal status of young adults with no third molar periodontal pathology at enrollment. J Oral MaxillofacSurg 2009;67(11), 2425-2430.

Kugelberg CF, Ahlström U, Ericson S, et al : Periodontal healing after impacted lower third molar surgery. A retrospective study.Int J Oral Surg1985; 14:29-40

Richardson DT, Dodson TB. Risk of periodontal defects after third surgery.An exercise in evidence-based clinical decision making.Oral Surg Oral Med, Oral Pathol Oral RadiolEndod2005;100(2):133-137.

Dicus C, Blakey GH, Faulk-Eggleston J, et al .Second molar periodontal inflammatory disease after third molar removal in young adults. J Oral MaxillofacSurg 2010;68:3000-3006.

Kan KW, Liu JK, Lo EC, Corbet EF and Leung WK. Residual periodontal defects distal to the mandibular second molar 6-36 months after impacted third molar extraction. J CliPeriodontol2002 ;29(11): 1004-1011.

Krausz AA, Machtei EE and Peled M .Effects of lower third molar extraction on attachment level and alveolar bone height of the adjacent second molar. Int J Oral MaxillofacSurg 2005;34(7): 756-760.

Godfrey K. Prophylactic removal of asymptomatic third molars: a review. Aust Dent J 1999;44:233–237.

Stephens RG, Kogon SL, Reid JA. The unerupted or impacted third molar: a critical appraisal of its patho- logic potential. J Can Dent Assoc 1989;55:201–207.

Hicks E: Third molar management: A case against routine removal in adolescent and young adult ortho- dontic patients. J Oral MaxillofacSurg1999;57:831.

Kim HS, Kim TK, Heo SR, Cho IH. The effect of third molar extraction on the periodontal status of the adjacent second molar.J Korean AcadPeriodontol. 2003 Sep;33(3):407-414.

.Montero J, Mazzaglia G. Effect of removing an impacted mandibular third molar on the periodontal status of the mandibular second molar.J Oral MaxillofacSurg2011;69:2691-2697.

Gröndahl HG and Lekholm U). Influence of mandibular third molars on related supporting tissues. Int J Oral Surg 1973;2(4): 137-142.

Kugelberg CF .Periodontal healing two and four years after impacted lower third molar surgery.A com- parative retrospective study.Int J Oral MaxillofacSurg 1990;19(6): 341–345.

Osborne WH, Snyder AJ and Tempel TR .Attachment levels and crevicular depths at the distal of man- dibular second molars following removal of adjacent third molars .J Periodontol 1982;53(2): 93–95.

Quee TA, Gosselin D, Millar EP and Stamm JW .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 .J Periodontol 1985; 56(10): 625– 630.

Dodson TB . Is there a role for reconstructive techniques to prevent periodontal defects after third molar surgery? J Oral MaxillofacSurg2005; 63(7): 891-896.

Kaminishi RM, Lam PS, Kaminishi KS, et al : A 10-year comparative study of the incidence of third molar removal in the aging population. J Oral MaxillofacSurg 2006; 64:173-174.

Listgarten MA. Periodontal probing: what does it mean? J ClinPeriodontol 1980; 7: 165–176.



  • There are currently no refbacks.