The influence of anatomical, pathophysiological and other factors on periodontal healing after impacted lower third molar surgery A multiple regression analysis

Abstract

A multifactorial approach has been used to identify some predictors of postoperative intrabony defects (IBD) on the distal surface of the adjacent second molar (M2) after impacted lower third molar (M3) surgery. The material consisted of 215 lower third molar removals, performed on 144 persons (age range 16-53 years; mean 27.2 years). The postoperative examination took place 2 years after impaction surgery and included both clinical and radiographic variables. Statistically significant (5% significance level) predictors of IBD found in stepwise multiple regression analyses were: (1) preoperative intrabony defect M2 distal; (2) age at the time of surgery; (3) size of contact-area M3/M2; (4) root resorption M2 distal; (5) probing dept distal surface of adjacent first molar postoperatively; (6) pathological follicle M3. The regression model with IBD as regressand produced a total R2 of 0.45. When the regressand was the difference between IBD and the preoperative intrabony defect, the regression analysis explained 62% of the variance (R2 = 0.62). These regression models explained the variance in terms of the size of the remaining postoperative intrabony defect as well as in terms of periodontal healing after impacted lower third molar surgery.

Radiological Infrabony Defects After Impacted Mandibular Third Molar Extractions in Young Adults

“…The present sample with an average age of 21.12 AE 4.80 years, as in the studies by Ash et al 1 and Kugelberg et al, 8,11,28 represents a group of young patients in whom age could determine the results.…”

“…1,6,7,9,11,28 Time is a variable that directly affects the results of the radiographic variables studied, as noted in other articles. 6,7,9,11,28 Many studies have compared bone changes in only 2 situations, usually before and after surgery, and with retrospective evaluations up to 12 months or with averages of a few years. 3,4,7,9,10,12 Only Ash et al 1 and Kugelberg et al 28 performed a prospective evaluation at 12 months.…”

“…11,12 However, there is a lack of homogeneity among study samples with regard to those factors highlighted by Coleman et al 13 who questioned the results obtained. In addition, different studies have used different radiographic methods of osseous evaluation, and technical errors often were not considered.…”

“…[1][2][3][4][5][6][7][8][9][10][11] Most of these studies have concluded that in 90% of cases, the presence of an impacted mesially inclined or horizontal M3 decreases the amount of bone in the distal aspect of the M2, and its extraction is associated with the presence of bone defects and infrabony periodontal pockets with loss of clinical attachment.…”

Comparison of Szmyd incision over envelope incision during the surgical removal of impacted third molar for evaluating postoperative prognosis: a prospective randomized study

“…This can cause pocket formation and loss of attachment in the area of the second molar. 14 The frequent occurrence of dehiscence distofacial to second molar seems to be another disadvantage of envelope flap design. Every gaping along the entire incision line was defined as a dehiscence.…”