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Journal of Peking University(Health Sciences) ›› 2020, Vol. 52 ›› Issue (1): 97-102. doi: 10.19723/j.issn.1671-167X.2020.01.015

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Application of β-TCP for bone defect restore after the mandibular third molars extraction: A split-mouth clinical trial

Chang CAO,Fei WANG,En-bo WANG(),Yu LIU()   

  1. Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2018-01-19 Online:2020-02-18 Published:2020-02-20
  • Contact: En-bo WANG,Yu LIU E-mail:ebwang-hlg@163.com;Liuyu4145@sina.com

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Abstract:

Objective: To evaluate the effect of bone defect regeneration and the periodontal status of the second molars after mandibular third molars extraction using β-tertiary calcium phosphate (β-TCP) in the test side compared with the spontaneously healed side. To the bone defect of mandibular second molars as a result of surgical removal of impacted mandibular third molars is a common phenomenon, many research shows that the mandibular second molars alveolar bone regeneration was about 1.5 mm and the periodontal pocket >7 mm was greater than 43.3% after mandibular third molars extraction. There has been significant progress researches in the repair of bone defect after the third molar removal, and bone graft filling was one of the effective methods. The bone graft substitutes include autogenous bone, allograft bone, xenograft bone and synthetic bone. Methods: A split mouth, randomized clinical study was designed. Fifteen patients with mandibular third molars in the same jaw planned to be extracted were enrolled in the study. One of the sockets of each patient was randomly selected and filled with easy-graft TMCLASSIC (test group). The contralateral socket was left to heal spontaneously (control group). cone beam computed tomography (CBCT) scans were performed the day after the extraction and after 6 months. The horizontal dimensional changes of the sockets were recorded. The newly formed bone volume in the bone was analyzed by CBCT, and the probing depth (PD) was recorded. Student’s t test was used to evaluate the difference between the two groups for each parameter, and the P value lower than 0.05 was considered to be statistically significant. Results: Fifteen patients (30 sockets) completed the flow-up, and all the 30 sockets healed uneventfully. After 6 months’ healing, the new bone volume fraction of the test group was 63.3%±2.2%, while the new bone volume fraction of the control group was 50.1%±1.9%. The vertical dimensional increment of the test group was (5.53±0.39) mm, while the vertical change of the control group was (1.53±0.27) mm. The distal buccal site PD of the second molar was (3.0±0.7) mm in the test group, and (6.5±0.8) mm in the control group. Statistically significant differences were detected between the two groups. Conclusion: The randomized controlled clinical trial showed that the application of β-TCP for bone defect repair after the mandibular third molars extraction resulted in more vertical bone regeneration and less probing depth when compared with what was spontaneously healed.

Key words: Bone defect repair, Cone beam computed tomography (CBCT), β-tertiary calcium phosphate (β-TCP)

CLC Number: 

  • R782.1

Figure 1

The appearance of easy-graftTMCLASSIC A, the appearance of easy-graftTMCLASSIC,bone graft substitutes were in the injection syringe; B, the molecular formula of miscible liquids on the right side."

Figure 2

Bone grafting for treatment of osseous defect after impacted mandibular third molar extraction A, bone defect after impacted mandibular third molar extraction; B, easy-graftTM CLASSIC grafting."

Figure 3

Confirm reference plane (RP) in CBCT"

Figure 4

MCTIPS make a binary image from original image (A) to binaryzation image (B)"

Figure 5

Preoperative (A)and postoperative 6-month (B) 3-D reconstruction of CBCT images of the control group"

Figure 6

Preoperative (A)and postoperative 6-month (B) 3-D reconstruction of CBCT images of the test group"

[1] Kugelberg CF . Impacted lower third molars and periodontal health. An epidemiological, methodological, retrospective and prospective clinical study[J]. Swed Dent J Suppl, 1990,68:1-52.
[2] Martin R, Louvrier A, Meyer C . Consequences of impacted wisdom teeth extraction on the periodontal environment of second molars, a pilot study[J]. J Stomatol Oral Maxillofac Surg, 2017,118(2):78-83
[3] Hassan KS, Marei HF, Alagl AS . Does grafting of third molar extraction sockets enhance periodontal measures in 30- to 35-year-old patients[J]. J Oral Maxillofac Surg, 2012,70(4):757-764.
[4] Kanr P, Maria A . Eficacy of platelet rich plasma and hydroxyapatite crystals in bone regeneration after surgical removal of mandibular third molars[J]. Maxillofac Oral Surg, 2013,12(1):51-59.
[5] Barbato L, Kalemaj Z, Buti J , et al. Effect of surgical intervention for removal of mandibular third molar on periodontal healing of adjacent mandibular second molar: a systematic review and bayesian network meta-analysis[J]. J Periodontol, 2016,87(3):291-302.
[6] Tabrizi R . Use of lincomycin-impregnated demineralized freeze-dried bone allograft in the periodontal defect after third molar surgery[J]. J Oral Maxillofac Surg, 2014,72(5):850-857.
[7] 刘树铭, 张祖燕, 李居朋 , 等. 健康青年人髁突松质骨结构锥形束CT分析[J]. 中华口腔医学杂志, 2007,42(6):357-360.
[8] Kan KW, Liu JK, Lo EC , et al. Residual periodontal defects distal to the mandibular second molar 6-36 months after impacted third molar extraction[J]. J Clin Periodontol, 2002,29(11):1004-1011.
[9] Leung WK, Corbet EF, Kan KW , et al. A regimen of systematic periodontal care after removal of impacted mandibular third molars manages periodontal pockets associated with the mandibular second molars[J]. J Clin Periodontol, 2005,32(7):725-731.
[10] Qu HL, Tian BM, Chen FM , et al. Effect of asymptomatic visible third molars on periodontal health of adjacent second molars: a cross-sectional study.[J] J Oral Maxillofac Surg, 2017,75(10):2048-2057
[11] Faria AI, Gallas-Torreira M, Lσpez-Ratσn M . Mandibular second molar periodontal healing after impacted third molar extraction in young adults[J]. J Oral Maxillofac Surg, 2012,70(12):2732-2741.
[12] Zimmerer RM, Jehn P, Kokemüller H , et al. In vivo tissue engineered bone versus autologous bone: stability and structure[J]. Int J Oral Maxillofac Surg, 2017,46(3):385-393.
[13] Jensen T, Schou S, Stavropoulos A , et al. Maxillary sinus floor augmentation with Bio-Oss or Bio-Oss mixed with autogenous bone as graft: a systematic review[J]. Clin Oral Implants Res, 2012,23(3):263-273.
[14] Ge J, Yang C, Zheng JW . Autogenous bone grafting for treatment of osseous defect after impacted mandibular third molar extraction: a randomized controlled trial[J]. Clin Implant Dent Relat Res, 2017,19(3):572-580.
[15] Drosos GI, Kazakos KI, Kouzoumpasis P , et al. Safety and eficacy of commercially available demineralised bone matrix preparations: a critical review of clinical studies[J]. Injury, 2007,38(Suppl 41):S13-21.
[16] Allen BA, Moudi E, Majidi MS , et al. A histologic, histomorphometric, and radiographic comparison between two complexes of CenoBoen/CenoMembrane and Bio-Oss/Bio-Gide in lateral ridge augmentation: a clinical trial[J]. Dent Res J (Isfahan), 2016,13(5):446-453.
[17] Ogihara S, Tarnow DP . Efficacy of enamel matrix derivative with freeze-dried bone allograft or demineralized freeze-dried bone allograft in intrabony defects: a randomized trial[J]. J Periodontol, 2014,85(10):1351-1360.
[18] Sammartino G, Tia M, Bucci T , et al. Prevention of mandibular third molar extraction-associated periodontal defects: a comparative study[J]. J Periodontol, 2009,80(3):389-396.
[19] Miron RL, Sculean A, Cochran DL , et al. Twenty years of enamel matrix derivative: the past, the present and the future[J]. J Clin Periodontol, 2016,43(8):668-683.
[20] Ho KN, Salamanca E, Chang KC , et al. A novel HA/β-TCP-collagen composite enhanced new bone formation for dental extraction socket preservation in beagle dogs[J]. Materials (Basel), 2016,9(3):191.
[21] Arenaz-Búa J, Luaces-Rey R, Sironvalle-Soliva S , et al. A comparative study of platelet-rich plasma, hydroxyapatite, demineralized bone matrix and autologous bone to promote bone regeneration after mandibular impacted third molar extraction[J]. Med Oral Patol Oral Cir Bucal, 2010,15(3):e483-489.
[22] Aloy-Prósper A, García-Mira B, Larrazabal-Morón C , et al. Distal probing depth and attachment level of lower second molars following surgical extraction of lower third molars: a literature review[J]. Med Oral Patol Oral Cir Bucal, 2010,15(5):e755-759.
[23] Aimetti M, Romano F . Use of resorbable membranes in periodontal defects treatment after extraction of impacted mandibular third molars[J]. Minerva Stomatol, 2007,56(10):497-508.
[24] Sammartino G, Tia M, Gentile E . Platelet-rich plasma and resorbable membrane for prevention of periodontal defects after deeply impacted lower third molar extraction[J]. J Oral Maxillofac Surg, 2009,67(11):2369-2373.
[25] Moghe S, Saini N, Moghe A . Platelet-rich plasma in periodontal defect treatment after extraction of impacted mandibular third molars. Natl J Maxillofac Surg, 2012,3(2):139-143.
[26] Montero J, Mazzaglia G . Effect of removing an impacted mandibular third molar on the periodontal status of the mandibular second molar[J]. J Oral Maxillofac Surg, 2011,69(11):2691-2697.
[27] Kugelberg CF, Ahlström U, Ericson S , et al. The influence of anatomical, pathophysiological and other factors on periodontal healing after impacted lower third molar surgery a multiple regression analysis[J]. J Clin Periodontol, 1991,18(1):37-43.
[28] Richardson DT, Dodson TB . Risk of periodontal defects after third molar surgery: an exercise in evidence-based clinical decision-making[J]. Oral Surg Oral Med Oral Path Oral Radiol Endod, 2005,100(2):133-137.
[29] Osborne WH, Snyder AJ, Tempel TR . Attachment levels and crevicular depths at the distal of mandibular second molars following removal of adjacent third molars[J]. J Periodontol, 1982,53(2):93-95.
[30] Chen YW, Lee CT, Chuang SK . Effect of flap design on periodontal healing after impacted third molar extraction: a systematic review and meta-analysis[J]. Int J Oral Maxillofac Surg, 2017,46(3):363-372.
[31] Korkmaz YT, Mollaoglu N, Ozmeriç N . Does laterally rotated flap design influence the short-term periodontal status of second molars and postoperative discomfort after partially impacted third molar surgery[J]. J Oral Maxillofac Surg, 2015,73(6):1031-1041.
[32] Kilinc A, Ataol M . How effective is collagen resorbable membrane placement after partially impacted mandibular third molar surgery on postoperative morbidity? A prospective randomized comparative study[J]. BMC Oral Health, 2017,17(1):126.
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