Management of Periodontal Defect after Mandibular Third Molar Extraction

Objectives: 1) to compare the regeneration with and without applying nanohydroxyapetite (nHA) bone graft and to determine if there is a clinical potential benefits of nHA in the regeneration on postextraction alveolar bone healing of distal bone defects of mandibular 2 nd molar, 2) to determine whether there are differences in postoperative clinical symptoms between the two groups. Study Design: a prospective, randomized controlled and double blinded study. The hypothesis is based on the extraction of impacted third molar in both groups by the same surgeon. A total of 50 patients were included in the present study, they were divided into two equal group. Group I treated by surgical extraction of impacted third molar with nHA on the socket, while Group II treated by surgical extraction of impacted third molar alone. Assessment of postoperative clinical symptoms (pain, swelling, trismus, infection), changes in probing depth and alveolar bone height and density at the distal second molar was done in both groups. Results: The highest acceleration in alveolar bone formation on the distal aspect of the adjacent second molar was observed on graft group. There were no statistically significant differences between groups regarding the clinical symptoms pain, swelling, trismus and infection. There was a significant reduction in probing pocket depth and increase in bone height and density at the end of study period in both groups. Conclusions: According to the results of the present study, the use of nanohydroxyapetite bone graft show improvement on height and density of alveolar bone and there was a significant reduction of the probing pocket depth. The clinical symptoms seems similar with nonsignificant differences between groups regarding pain, swelling, trismus and infection.