Study Of Second Molar Distal Bone Defect Restoration With Atelo-collagen After Mandibular Third Molars Extraction

Objective:Mandibular third molars are the most common impacted teeth in human,which can cause pericoronitis,pain,mouth opening limitation,maxillofacial swelling and space infection.Mandibular third molars could cause problems in adjacent soft tissue,alveolar bone and even adjacent teeth.Preventive extraction of mandibular third molars has become the consensus of most oral clinicians.The alveolar bone between the horizontal impacted mandibular third molar and the adjacent teeth is often absent.Improper treatment after mandibular third molar extraction may result in the defect of the distal alveolar bone of the second molar.The collagen of teruplug is a kind of reticular porous and rough surface biomaterial with weak antigenicity.Its surface reticular structure is not only conducive to blood adsorption and aggregation,but also absorb surrounding tissue cells to form new tissues in the structure,showed good ability of bone tissue healing.Therefore,the purpose of this study is :1.To investigate the clinical effect of atelo-collagen on preventing the postoperative complications of mandibular third molar extraction.2.To investigate application of atelo-collagen for second molar distal bone defect restoration after the mandibular third molars extraction.Methods:From January 2019 to July 2019,134 patients who came to have their mandibular third molars extracted in the department of maxillofacial surgery of the stomatological of Shanxi Medical University were included in the study.The same imaging technician used the same equipment to conduct curved slice,and preoprative oral examination was performed by the same doctor.A total of 168 mandibular third molars were extracted,and they were randomly divided into two groups.Atelo-collagen was implanted in the extracted socket in the experimental group and nothing was implanted into the alveolar socket in control group.Postoperative bleeding,pain,trismus and dry socket were recorded after surgery.Spss24.0software package was used to analyze the measured data.32 patients with bilateral mandibular third molars diagnosed as horizontal median impacted by oral examination and imaging findings were selected in this study.Preoperatively,the same surgeon measured and recorded the probing depth on the distal buccal side of bilateral second molars with a standard periodontal probe.After extraction,the same person’s tooth sockets were divided into two groups:the control group and the atelo-collagen group.The tooth sockets in the control group were filled with colloidal silver gelatin sponge,while that in the atelo-collagen group were filled with atelo-collagen.The assessments of distal buccal probing depth of the second molar and X-ray examination were recorded postoperative in 3,6 mouths.Spss24.0 software package was used to analyze the measured data.Results:1.The clinical effect of atelo-collagen on preventing the postoperative complications of mandibular third molar extraction.(1)The bleeding and trismus after surgery of the experimental group were significantly lower than those of the control group.The results were statistically significant.It is suggested that teruplug collagen can relieve bleeding and mouth opening limitation after tooth extraction.(2)The VAS of the experimental group at 24 h and 2d after surgery was lower than that of the control group,and the difference was statistically significant,while the pain degree of the two groups at 7d after surgery had no statistically significant difference.It is suggested that teruplug collagen can not increase early postoperative pain.(3)Seven days after operation,there were 9 cases(10.7%)of tooth extraction dehiscence and 3 cases(3.6%)of dry sockets in the control group,while there were only 2cases(3%)of tooth extraction dehiscence and 1 case(1%)of dry sockets in the experimental group,the difference of tooth extraction dehiscence was statistically significant.2.Effect of atelo-collagen for second molar distal bone defect restoration after the mandibular third molars extraction.(1)48h after surgery,the pain degree of patients in the experimental group(2.67±1.10)was lower than that in the control group(3.31±0.20),the difference was statistically significant.(2)The distal probing depth of the second molar in both the experimental group and the control group was lower than that before operation(4.20±1.82,4.40±2.27),but there was no significant difference between the groups 3 months and 6 months after operation(P > 0.05).(3)The CBCT showed obvious bone trabecular structure in the distal new bone of the second molar at 3 and 6 months after surgery.The measurement results showed that the bone height and bone density of the new bone in the experimental group were higher than those in the control group,and the differences were statistically significant.(4)The volume of the new bone in the experimental group were higher than those in the control group at 3 and 6 months after surgery.There was significant difference between the two groups.Conclusions:1.The Atelo-collagen can effectively prevent postoperative bleeding and dry socket after teeth extraction,which is beneficial to the early healing of tooth extraction wounds.2.The Atelo-collagen can reduce the probing depth of the distal side of the second molar after the mandibular third molar extraction,and it is conducive to the reconstruction of the alveolar bone defect.