Dentoalveolar surgery
Use of Lincomycin-Impregnated Demineralized Freeze-Dried Bone Allograft in the Periodontal Defect After Third Molar Surgery

https://doi.org/10.1016/j.joms.2013.11.028Get rights and content

Purpose

The aim of the present study was to evaluate the periodontal regenerative capacity of demineralized freeze-dried bone allograft (DFDBA) alone or used with local lincomycin.

Materials and Methods

In the present single-blind, randomized, controlled clinical trial, 20 subjects 26 years old or older, requiring extraction of bilateral third molars (M3s), were included. Each subject was randomly assigned to receive either DFDBA or DFDBA plus lincomycin therapy. Within the subjects, 1 M3 site was randomly selected to be the experimental site and the contralateral served as the control and was permitted to heal without intervention. The primary variables were changes in the probing depth (PD), clinical alveolar bone levels (ABLs), and radiographic alveolar bone density (ABD) on the distal aspect of second molar between baseline (immediately postoperatively) and 26 weeks postoperatively (T26). Appropriate sample sizes and descriptive, bivariate, and multivariate statistics were computed.

Results

For both treatment and control sites, between T0 and T26, statistically significant improvements were seen in the ABLs and ABD (P < .05). Within-subject comparisons showed no significant differences in PD, ABL, or ABD between the treatment and control M3 sites at T0 or T26 (P > .05). Also, no significant differences were found in the PD, ABL, or ABD between the 2 treatment M3 sites at T26 (P > .05).

Conclusions

The results of the present study have revealed that the PD, ABL, and ABD improved after M3 removal in subjects 26 years old or older, irrespective of the treatment or control group. Reconstructive procedures (eg, DFDBA with or without lincomycin therapy) did not offer predictable benefits compared with a no-treatment protocol in patients younger than 30 years old.

Section snippets

Materials and Methods

The original cohort included 20 subjects recruited from November 2011 to July 2012, in a split-mouth, randomized, single-blind, controlled clinical trial, at the maxillofacial surgery department (Shiraz University of Medical Science School of Dentistry, Shiraz, Iran). The inclusion criteria consisted of bilateral mandibular impacted M3s and risk factors for M2 periodontal defects after M3 removal: age 26 years or older and a fully impacted mesioangular or horizontal M3 position.8

The present

Results

The original cohort included 20 subjects, and a total of 40 M3 extraction sites were evaluated. The mean age ± standard deviation was 26.5 ± 1.9 years (range 25-30). Of the 20 subjects, 6 (30%) were men. The tooth-specific variables for the study groups (treatment and control) are summarized in Table 1. No statistically significant differences were found in the distribution of the study variables among the groups (P > .05). Clinical evaluation of the postoperative healing revealed an excellent

Discussion

Extraction of lower M3s can result in a periodontal defect at the distal aspect of the lower M2, characterized by an increased PD (distance from the free gingival margin to the bottom of the gingival sulcus), an increased attachment level (distance from the free gingival margin to the cementoenamel junction), and a decreased alveolar bone height.19

In such cases, a predictable method to minimize the risk of M2 periodontal defects is desired. This issue has been studied using a variety of

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      We included 7 articles for data analysis21,22,35-39; however, we selected only 6 studies21,22,35-38 to calculate WDCAL and only 6 studies21,22,36-39 to calculate WDPD. We excluded 1 study39 from WDCAL analysis, and we excluded 1 study35 from WDPD analysis because the investigators of these 2 studies35,39 did not provide the clinical information we required. The procedures used in these studies included osseous grafting, GTR, and combination technique (Table 121,22,35-39).

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    Conflict of Interest Disclosures: None of the authors reported any disclosures.

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