Skip to main content
Erschienen in: Clinical Oral Investigations 4/2019

25.08.2018 | Original Article

Guided bone regeneration to reduce root migration after coronectomy of lower third molar: a randomized clinical trial

verfasst von: Yiu Yan LEUNG

Erschienen in: Clinical Oral Investigations | Ausgabe 4/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Root migration occurs after most third molar coronectomy and a portion may be exposed in the oral cavity. This study compared the root migration rate, surgical morbidities after third molar coronectomy with or without adjunctive guided bone regeneration (GBR).

Methods

A split-mouth randomized clinical trial was conducted on patients with bilateral lower third molars close to the inferior alveolar nerve. One side of the lower third molars was randomized to receive coronectomy with adjunctive GBR (study group) and the other side received coronectomy alone (control group). The cases were followed up for 2 years. Root migration, root exposure rate, surgical morbidities, and adjacent second molar periodontal regeneration were analyzed.

Results

Forty-eight subjects (19 males, 29 females) with a mean age of 2.6 years (SD 5.8 years) were recruited. There was no root exposure in the review period. There were no statistical differences in pain and infection rate between the two groups at all time-points. The root migration was significantly less in the study group than the control group from 3 months onwards, and migrated only 1 mm (SD 1.3 mm) in 2 years (versus 3.5 mm (S.D.1.9 mm) in the control group). There were no differences in the periodontal attachment regeneration between the two groups.

Conclusions

Root migration in coronectomy with adjunctive GBR was less when compared with coronectomy alone, and with similar surgical morbidities and periodontal regeneration of adjacent second molars.

Clinical relevance

Minimal root migration occurred in coronectomy with adjunctive GBR. The chance of long-term (3 years or more) root exposure and the need of subsequent second operation to remove the exposed root would be reduced.
Literatur
1.
Zurück zum Zitat Garaas R, Moss KL, Fisher EL, Wilson G, Offenbacher S, Beck JD, White RP Jr (2011) Prevalence of visible third molars with caries experience or periodontal pathology in middle-aged and older Americans. J Oral Maxillofac Surg 69:463–470CrossRefPubMed Garaas R, Moss KL, Fisher EL, Wilson G, Offenbacher S, Beck JD, White RP Jr (2011) Prevalence of visible third molars with caries experience or periodontal pathology in middle-aged and older Americans. J Oral Maxillofac Surg 69:463–470CrossRefPubMed
2.
Zurück zum Zitat Queral-Godoy E, Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C (2005) Incidence and evolution of inferior alveolar nerve lesions following lower third molar extraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 99:259–264CrossRefPubMed Queral-Godoy E, Valmaseda-Castellon E, Berini-Aytes L, Gay-Escoda C (2005) Incidence and evolution of inferior alveolar nerve lesions following lower third molar extraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 99:259–264CrossRefPubMed
3.
Zurück zum Zitat Leung YY, Cheung LK (2011) Risk factors of neurosensory deficits in lower third molar surgery: an literature review of prospective studies. Int J Oral Maxillofac Surg 40:1–10CrossRefPubMed Leung YY, Cheung LK (2011) Risk factors of neurosensory deficits in lower third molar surgery: an literature review of prospective studies. Int J Oral Maxillofac Surg 40:1–10CrossRefPubMed
4.
Zurück zum Zitat Leung YY, McGrath C, Cheung LK (2013) Trigeminal neurosensory deficit and patient reported outcome measures: the effect on quality of life. PLoS One 29(8):e77391CrossRef Leung YY, McGrath C, Cheung LK (2013) Trigeminal neurosensory deficit and patient reported outcome measures: the effect on quality of life. PLoS One 29(8):e77391CrossRef
5.
Zurück zum Zitat Leung YY, Cheung LK (2009) Safety of coronectomy versus excision of wisdom teeth: a randomized controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:821–827CrossRefPubMed Leung YY, Cheung LK (2009) Safety of coronectomy versus excision of wisdom teeth: a randomized controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:821–827CrossRefPubMed
6.
Zurück zum Zitat Renton T, Hankins M, Sproate C, McGurk M (2005) A randomised controlled clinical trial to compare the incidence of injury to the inferior alveolar nerve as a result of coronectomy and removal of mandibular third molars. Br J Oral Maxillofac Surg 43:7–12CrossRefPubMed Renton T, Hankins M, Sproate C, McGurk M (2005) A randomised controlled clinical trial to compare the incidence of injury to the inferior alveolar nerve as a result of coronectomy and removal of mandibular third molars. Br J Oral Maxillofac Surg 43:7–12CrossRefPubMed
7.
Zurück zum Zitat O'Riordan BC (2004) Coronectomy (intentional partial odontectomy of lower third molars). Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 98:274–280CrossRefPubMed O'Riordan BC (2004) Coronectomy (intentional partial odontectomy of lower third molars). Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 98:274–280CrossRefPubMed
8.
Zurück zum Zitat Karapataki S, Hugoson A, Kugelberg CF (2000) Healing following GTR treatment of bone defects distal to mandibular 2nd molars after surgical removal of impacted 3rd molars. J Clin Periodontol 27:325–332CrossRefPubMed Karapataki S, Hugoson A, Kugelberg CF (2000) Healing following GTR treatment of bone defects distal to mandibular 2nd molars after surgical removal of impacted 3rd molars. J Clin Periodontol 27:325–332CrossRefPubMed
9.
Zurück zum Zitat Karapataki S, Hugoson A, Falk H, Laurell L, Kugelberg CF (2000) Healing following GTR treatment of intrabony defects distal to mandibular 2nd molars using resorbable and non-resorbable barriers. J Clin Periodontol 27:333–340CrossRefPubMed Karapataki S, Hugoson A, Falk H, Laurell L, Kugelberg CF (2000) Healing following GTR treatment of intrabony defects distal to mandibular 2nd molars using resorbable and non-resorbable barriers. J Clin Periodontol 27:333–340CrossRefPubMed
10.
Zurück zum Zitat Leung YY (2016) Coronectomy of lower third molars with and without guided bony regeneration: a pilot study. Br J Oral Maxillofac Surg 54:155–159CrossRefPubMed Leung YY (2016) Coronectomy of lower third molars with and without guided bony regeneration: a pilot study. Br J Oral Maxillofac Surg 54:155–159CrossRefPubMed
11.
Zurück zum Zitat Schulz KF, Altman DG, Moher D, for the CONSORT Group (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Trials 11:32CrossRefPubMedPubMedCentral Schulz KF, Altman DG, Moher D, for the CONSORT Group (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Trials 11:32CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Leung YY, Cheung LK (2011) Correlation of radiographic signs, inferior dental nerve exposure and deficit in wisdom tooth surgery. J Oral Maxillofac Surg 69:1873–1879CrossRefPubMed Leung YY, Cheung LK (2011) Correlation of radiographic signs, inferior dental nerve exposure and deficit in wisdom tooth surgery. J Oral Maxillofac Surg 69:1873–1879CrossRefPubMed
13.
Zurück zum Zitat Leung YY, Cheung KY. (2018) Root migration pattern after third molar coronectomy: a long-term analysis. Int J Oral Maxillofac Surg pii: S0901–5027(18)30033-X, 47, 802, 808 Leung YY, Cheung KY. (2018) Root migration pattern after third molar coronectomy: a long-term analysis. Int J Oral Maxillofac Surg pii: S0901–5027(18)30033-X, 47, 802, 808
14.
Zurück zum Zitat Knutsson K, Lysell L, Rohlin M (1989) Postoperative status after partial removal of the mandibular third molar. Swed Dent J 13:15–22PubMed Knutsson K, Lysell L, Rohlin M (1989) Postoperative status after partial removal of the mandibular third molar. Swed Dent J 13:15–22PubMed
15.
Zurück zum Zitat Leung YY, Cheung LK (2012) Coronectomy of the lower third molar is safe within the first 3 years. J Oral Maxillofac Surg 70:1515–1522CrossRefPubMed Leung YY, Cheung LK (2012) Coronectomy of the lower third molar is safe within the first 3 years. J Oral Maxillofac Surg 70:1515–1522CrossRefPubMed
16.
Zurück zum Zitat Leung YY, Cheung LK (2016) Long-term morbidities of coronectomy on lower third molar. Oral Surg Oral Med Oral Pathol Oral Radiol 121:5–11CrossRefPubMed Leung YY, Cheung LK (2016) Long-term morbidities of coronectomy on lower third molar. Oral Surg Oral Med Oral Pathol Oral Radiol 121:5–11CrossRefPubMed
17.
Zurück zum Zitat Yeung AWK, Wong NSM, Bornstein MM, Leung YY. (2018) Three-Dimensional Radiographic Evaluation of Root Migration Patterns 4–8.5 Years After Lower Third Molar Coronectomy: A Cone Beam Computed Tomography Study. Int J Oral Maxillofac Surg. In press Yeung AWK, Wong NSM, Bornstein MM, Leung YY. (2018) Three-Dimensional Radiographic Evaluation of Root Migration Patterns 4–8.5 Years After Lower Third Molar Coronectomy: A Cone Beam Computed Tomography Study. Int J Oral Maxillofac Surg. In press
18.
Zurück zum Zitat Garcia-Garcia A (2006) Is coronectomy really preferable to extraction? Br J Oral Maxillofac Surg 44:75CrossRefPubMed Garcia-Garcia A (2006) Is coronectomy really preferable to extraction? Br J Oral Maxillofac Surg 44:75CrossRefPubMed
19.
Zurück zum Zitat Freedman GL (1997) Intentional partial odontectomy: review of cases. J Oral Maxillofac Surg 55:524–526CrossRefPubMed Freedman GL (1997) Intentional partial odontectomy: review of cases. J Oral Maxillofac Surg 55:524–526CrossRefPubMed
20.
Zurück zum Zitat Pogrel MA, Lee JS, Muff DF (2004) Coronectomy: a technique to protect the inferior alveolar nerve. J Oral Maxillofac Surg 62:1447–1452CrossRefPubMed Pogrel MA, Lee JS, Muff DF (2004) Coronectomy: a technique to protect the inferior alveolar nerve. J Oral Maxillofac Surg 62:1447–1452CrossRefPubMed
21.
Zurück zum Zitat Dolanmaz D, Yildirim G, Isik K, Kucuk K, Ozturk A (2009) A preferable technique for protecting the inferior alveolar nerve: Coronectomy. J Oral Maxillofac Surg 67:1234–1238CrossRefPubMed Dolanmaz D, Yildirim G, Isik K, Kucuk K, Ozturk A (2009) A preferable technique for protecting the inferior alveolar nerve: Coronectomy. J Oral Maxillofac Surg 67:1234–1238CrossRefPubMed
22.
Zurück zum Zitat Goto S, Kurita K, Kuroiwa Y, Hatano Y, Kohara K, Izumi M, Ariji E (2012) Clinical and dental computed tomographic evaluation 1 year after coronectomy. J Oral Maxillofac Surg 70:1023–1029CrossRefPubMed Goto S, Kurita K, Kuroiwa Y, Hatano Y, Kohara K, Izumi M, Ariji E (2012) Clinical and dental computed tomographic evaluation 1 year after coronectomy. J Oral Maxillofac Surg 70:1023–1029CrossRefPubMed
23.
Zurück zum Zitat Horváth A, Mardas N, Mezzomo LA, Needleman IG, Donos N (2013) Alveolar ridge preservation. A systematic review. Clin Oral Investig 17:341–363CrossRefPubMed Horváth A, Mardas N, Mezzomo LA, Needleman IG, Donos N (2013) Alveolar ridge preservation. A systematic review. Clin Oral Investig 17:341–363CrossRefPubMed
24.
Zurück zum Zitat Needleman IG, Worthington HV, Giedrys-Leeper E, Tucker RJ (2006) Guided tissue regeneration for periodontal infra-bony defects. Cochrane Database Syst Rev 19:CD001724 Needleman IG, Worthington HV, Giedrys-Leeper E, Tucker RJ (2006) Guided tissue regeneration for periodontal infra-bony defects. Cochrane Database Syst Rev 19:CD001724
25.
Zurück zum Zitat Karapataki S, Hugoson A, Kugelberg CF (2000) Healing following GTR treatment of bone defects distal to mandibular 2nd molars after surgical removal of impacted 3rd molars. J Clin Periodontol 27:325–332CrossRefPubMed Karapataki S, Hugoson A, Kugelberg CF (2000) Healing following GTR treatment of bone defects distal to mandibular 2nd molars after surgical removal of impacted 3rd molars. J Clin Periodontol 27:325–332CrossRefPubMed
26.
Zurück zum Zitat Kugelberg CF, Ahlström U, Ericson S, Hugoson A, Kvint S (1991) Periodontal healing after impacted lower third molar surgery in adolescents and adults. A Prospective Study Int J Oral Maxillofac Surg 20:18–24CrossRefPubMed Kugelberg CF, Ahlström U, Ericson S, Hugoson A, Kvint S (1991) Periodontal healing after impacted lower third molar surgery in adolescents and adults. A Prospective Study Int J Oral Maxillofac Surg 20:18–24CrossRefPubMed
27.
Zurück zum Zitat Kugelberg CF, Ahlström U, Ericson S, Hugoson A, Thilander H (1991) The influence of anatomical, pathophysiological and other factors on periodontal healing after impacted lower third molar surgery. A multiple regression analysis. J Clin Periodontol 18:37–43CrossRefPubMed Kugelberg CF, Ahlström U, Ericson S, Hugoson A, Thilander H (1991) The influence of anatomical, pathophysiological and other factors on periodontal healing after impacted lower third molar surgery. A multiple regression analysis. J Clin Periodontol 18:37–43CrossRefPubMed
28.
Zurück zum Zitat Leizerovitz M, Leizerovitz O (2013) Modified and grafted coronectomy: a new technique and a case report with two-year followup. Case Rep Dent 2013:914173PubMedPubMedCentral Leizerovitz M, Leizerovitz O (2013) Modified and grafted coronectomy: a new technique and a case report with two-year followup. Case Rep Dent 2013:914173PubMedPubMedCentral
29.
Zurück zum Zitat Leizerovitz M, Leizerovitz O (2013) Reduced complications by modified and grafted coronectomy vs. standard coronectomy--a case series. Alpha Omegan 106:81–89PubMed Leizerovitz M, Leizerovitz O (2013) Reduced complications by modified and grafted coronectomy vs. standard coronectomy--a case series. Alpha Omegan 106:81–89PubMed
Metadaten
Titel
Guided bone regeneration to reduce root migration after coronectomy of lower third molar: a randomized clinical trial
verfasst von
Yiu Yan LEUNG
Publikationsdatum
25.08.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Oral Investigations / Ausgabe 4/2019
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-018-2594-8

Weitere Artikel der Ausgabe 4/2019

Clinical Oral Investigations 4/2019 Zur Ausgabe

Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Zahnmedizin und bleiben Sie gut informiert – ganz bequem per eMail.