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Factors affecting periodontal healing of the adjacent second molar after lower third molar surgery: a systematic review and meta-analysis

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Abstract

Objectives

This systematic review and meta-analysis aim to evaluate the effect modifiers which may influence the periodontal healing of the adjacent second molar after lower third molar surgery.

Materials and methods

Prospective studies including patients with third molars requiring removal, with at least 6 months follow-up were considered. Outcomes were periodontal probing depth (PPD) reduction, final PPD, clinical attachment level (CAL) change, final CAL, alveolar bone defect (ABD) reduction, and final ABD depth. Meta-regression was performed to identify factors.

Results

Fourteen studies were included in the quantitative synthesis. At 6 months, the PPD reduction was 1.06 mm (95% CI, 0.72 to 1.39 mm) and the remaining PPD was 3.81 mm (95% CI, 3.00 to 4.62 mm). Baseline PPD was strongly correlated with the remaining PPD at 6 months (p < 0.001, adjusted R2 = 70.05%).

Conclusions

Lower third molar surgery results in a modest reduction in PPD, CAL, and ABD; however, periodontal defects still remain at 6 months and beyond. Baseline PPD is strongly correlated with final PPD. While age is not shown to have effect on most of the periodontal parameters, a larger baseline PPD is more likely to manifest with increasing age and third molar surgery should be done before severe periodontitis occurs to avoid persistent periodontal defects.

Clinical relevance

This study shows that lower third molar surgery results in modest improvement in periodontal parameters on adjacent second molars and identified factors such as baseline PPD which may affect the healing, which may guide the pre-, peri-, and post-operative management of lower third molar surgery.

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Authors and Affiliations

  1. Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong

    Si Ling Pang, Karen Pui Yan Leung & Yiu Yan Leung

  2. Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong

    Kar Yan Li

  3. Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong

    George Pelekos & Maurizio Tonetti

  4. China Shanghai PerioImplant Innovation Center, National Clinical Research Center of Stomatology, Ninth People’ Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Maurizio Tonetti

  5. European Research Group On Periodontology, Genova, Italy

    Maurizio Tonetti

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  1. Si Ling Pang
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  2. Karen Pui Yan Leung
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  3. Kar Yan Li
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  4. George Pelekos
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  5. Maurizio Tonetti
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  6. Yiu Yan Leung
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Contributions

SL Pang: conceptualization, methodology, formal analysis, data curation, writing—original draft, writing—review and editing, visualization; KPY Leung: methodology, formal analysis, data curation; Kar Yan LI: methodology, formal analysis, data curation; G Pelekos: writing—review and editing, supervision; M Tonetti: writing—review and editing, supervision; YY Leung: conceptualization, writing—review and editing, supervision.

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Correspondence to Yiu Yan Leung.

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Pang, S.L., Leung, K.P.Y., Li, K.Y. et al. Factors affecting periodontal healing of the adjacent second molar after lower third molar surgery: a systematic review and meta-analysis. Clin Oral Invest 27, 1547–1565 (2023). https://doi.org/10.1007/s00784-022-04777-3

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