Document Detail

Risk of periodontal defects after third molar surgery: An exercise in evidence-based clinical decision-making.
MedLine Citation:
PMID:  16037768     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The object of this study was to apply evidence-based principles to answer the question, What is the risk of having periodontal defects on the distal aspect of the mandibular second molar (M2) following third molar (M3) removal? STUDY DESIGN: To identify relevant articles for review, we completed a computerized literature search of Medline. The inclusion criteria for articles included prospective cohort studies or randomized clinical trials with follow-up periods of 6 months or more, and preoperative and postoperative measurements of periodontal probing depths (PDs) or attachment levels (ALs). RESULTS: Eight articles met the inclusion criteria. Overall, the reported mean changes in ALs or PDs on the distal of M2 6 months after M3 removal were clinically insignificant, ie, less than 2 mm. Six months after M3 removal, 52% to 100% of subjects had no change or improvement in ALs or PDs. Given periodontal disease present preoperatively, the number needed to treat (NNT) ranged from 3 to 10. Given healthy periodontal status preoperatively, 48% had worsening of their periodontal measures after M3 removal and the number needed to harm (NNH) was 2. CONCLUSION: Commonly, the second molar periodontal probing depth or attachment levels either remain unchanged or improve after third molar removal. For subjects with healthy second molar periodontium preoperatively, the indication for third molar removal needs to be evaluated carefully as these subjects have an increased risk for worsening of probing depths or attachment levels after third molar removal.
Daniel T Richardson; Thomas B Dodson
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics     Volume:  100     ISSN:  1528-395X     ISO Abbreviation:  Oral Surg Oral Med Oral Pathol Oral Radiol Endod     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-07-22     Completed Date:  2006-02-10     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9508562     Medline TA:  Oral Surg Oral Med Oral Pathol Oral Radiol Endod     Country:  United States    
Other Details:
Languages:  eng     Pagination:  133-7     Citation Subset:  D; IM    
Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
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MeSH Terms
Alveolar Bone Loss / etiology*
Decision Making
Evidence-Based Medicine
Molar, Third / surgery*
Periodontal Attachment Loss / etiology*
Risk Factors
Tooth Extraction / adverse effects*
Tooth, Impacted / surgery
Grant Support
Comment In:
Evid Based Dent. 2006;7(2):46   [PMID:  16858381 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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