Collagen Treatment After Wisdom Teeth Removal

An interesting article titled “Effects of Collagen Resorbable Membrane Placement After the Surgical Extraction of Impacted Lower Third Molars,” appears in the 2015 Journal of Oral and Maxilofacial Surgery (vol. 73, pp. 1457-1464) written by Isidoro Cortell-Ballester and et. al. The article explores the use of resorbable collagen membranes (RMs) in the healing of a bone defect on the distal side of a lower second molar (L2M) after surgical extraction of an impacted lower wisdom tooth.

In recent years, various clinical studies have been carried out to evaluate the efficacy of guided tissue regeneration in the treatment of intraosseous defects and deep periodontal pockets on the distal aspect of lower second molars after surgical extraction of impacted wisdom teeth. Nonresorbable expanded tetrafluoroethylene membranes, resorbable polylactic acid and resorbable collagen membranes (RMs), bone graft substitutes, and platelet-rich plasma (PRP) have been used. The authors carried out a randomized, double-blinded clinical trial on guided tissue regeneration of intraosseous defects and deep periodontal pockets on the distal surface of L2Ms after surgical extraction of horizontal or mesioangular impacted wisdom teeth.

The sample size was calculated at 25 patients per group to detect differences in the bone level variable of 2 mm at 6 months (allocation ratio, 1:1; a = 0.05; power, 0.8; s = 1.5 mm). Five additional patients per group were recruited to compensate for dropouts and as such 60 patients total were included.  After extraction, patients received an RM
or only suture.

The distal vestibular, distal, and distolingual probing depths of the L2M, distal vestibular attachment level, distance from the cementoenamel junction, and distance from the alveolar crest to the base of the defect showed greater improvement 6 months after surgical extraction in the RM group. The authors recommend RM placement after surgical extraction of impacted wisdom teeth because it prevents periodontal defects after surgery. The use of RMs after surgical extraction of impacted mesioangular or horizontal wisdom teeth improved the probing attachment level and bone fill at the lower second molar. The authors recommend a longer term future follow up study.

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