| ObjectiveThe extraction of impacted mandibular wisdom teeth and the simultaneous implantation of artificial bone powder and biofilm with naturally healed extraction fossa were compared and analyzed.the bone yield of distal alveolar bone of adjacent teeth and its periodontal effect were observed.MethodFrom December 2017 to October 2018,41 patients with near-middle or horizontal impacted mandibular six molars were collected in our department.They were randomly divided into two groups.Artificial bone powder and biofilm were implanted in the treatment group and blank control group.There were 17 cases in the treatment group and 24 cases in the control group.The probing depth(Probing Depth,PD)and attachment loss(Attachment Loss,AL)of the distal surface of adjacent second molars were examined by the operator before operation in both groups.The distance from the top of the distal alveolar ridge of the adjacent second molar to the junction of enamel dentin was measured by curved surface tomography.17 patients in the treatment group were removed mandibular impacted teeth at the same time,artificial bone powder was implanted,the height reached the distal enamel cementum boundary of adjacent second molars,and covered with biofilm,suture,biting cotton to stop bleeding,while the control group extracted mandibular impacted teeth and routinely treated extraction wounds.When revisiting and removing the thread,the two groupsof patients were examined for tooth extraction wound(with or without postoperative complications),tooth sensitivity or cold and heat stimulation discomfort,and so on.At 6 months after operation,the probing depth and attachment loss of the distal surface of adjacent second molars were recorded,and the distance from the top of distal alveolar ridge to the junction of enamel dentin was measured by curved surface tomography.The difference between the distance recorded before operation and the distance recorded before operation was used as the amount of bone acquisition(Bone Gain,BG).Result1.When all patients were revisited and removed,there was no infection,dry socket disease and foreign body reaction in tooth extraction wound.there was no tooth sensitivity in the treatment group,2 cases of cold and heat stimulation discomfort in the treatment group and 5 cases of tooth sensitivity in the control group by examining the distal surface of the adjacent mandibular second molar.There were 10 cases of cold and heat stimulation discomfort(including tooth sensitivity).2.Six months after operation,all patients were examined for tooth extraction wound,tooth extraction wound had been filled with alveolar bone,and the distal surface of adjacent mandibular second molars was examined again.there was no tooth sensitivity in the treatment group and no tooth sensitivity in the control group.However,there were 7 cases of cold and heat stimulation discomfort,2 cases less than when the thread was removed and revisited.3.Six months after operation,the distance from the top of the distal alveolar ridge to the enamel boundary of the adjacent second molars in the treatment group(2.8 ±1.08mm),was significantly smaller than that before operation(8.39 ±1.68 mm).There was significant difference between the two groups(P < 0.01).Six months after operation,the probing depth in the treatment group(2.88 ±0.70 mm),)was significantly lower than that before operation(6.23 ±1.30 mm)(P < 0.01).Six months after operation,the loss of attachment(0.81 ±0.54 mm),)was significantly lower than that before operation(3.63 ±1.09 mm)(P < 0.01).Six months after operation,the distance fromthe top of the distal alveolar ridge to the enamel boundary of the adjacent second molars(5.42 ±1.60 mm),)was significantly smaller than that before operation(7.96±1.54 mm).Six months after operation,the probing depth of the control group(4.71±1.00 mm),)was significantly lower than that of the preoperative probing depth(6.08±1.18 mm)(P < 0.01).Six months after operation,the attachment loss was(1.88±0.74 mm),which was significantly lower than that before operation(3.25 ±1.11).4.There was no significant difference in preoperative probing depth between the treatment group(6.23 ±1.30 mm)and the control group(6.08 ±1.18 mm).The postoperative probing depth in the treatment group(2.88 ±0.70 mm)was significantly lower than that in the control group(4.71 ±1.00 mm),)(P < 0.01).There was no significant difference in preoperative attachment loss between the treatment group(3.63 ±1.09 mm)and the control group(3.25 ±1.11 mm).The postoperative attachment loss in the treatment group(0.81 ±0.54 mm)was significantly lower than that in the control group(1.88 ±0.74 mm),)(P < 0.01).The bone gain in the treatment group(4.07 ±0.96 mm)was significantly higher than that in the control group(2.31±0.56 mm),)(P < 0.01).Conclusion1.At the same time of mandibular low proximal or horizontal impacted tooth extraction,artificial bone powder and biofilm were implanted to accelerate the regeneration of distal alveolar bone of adjacent mandibular second molars.2.At the same time of extraction of mandibular low proximal or horizontal impacted teeth,implantation of artificial bone powder and biofilm is beneficial to the health of distal periodontal of adjacent mandibular second molars. |
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