Early removal of unerupted wisdom teeth results in positive gum outcomes

In a study published in the March issue of the Journal of Oral and Maxillofacial Surgery, the official journal of the AAOMS, average probing pocket depth (PPD) and clinical attachment level (CAL) of the teeth — the second molars — are variables that improve over time after removal of the adjacent wisdom teeth, also known as third molars, when they were unerupted rather than emerging through the gum tissue.

PPD and CAL are used to assess gum disease. Wisdom teeth removal can impact gum tissues of nearby second molars, the study notes. PPD was measured from the edge of the gums to the base of the pocket — a space between the tooth and the gums. For the study, PPD of at least 4 mm was considered diseased.

A probe also measured CAL, which provides information on bone loss and gum disease progress by calculating the distance from the base of the pocket to where the tooth enamel meets the root’s covering.

The study’s 39 patients, who averaged nearly 22 years old, needed removal of their wisdom teeth because of orthodontic reasons. Each patient had one or two unerupted wisdom teeth without symptoms in their lower jaw. Their PPD and CAL changes were measured before surgery and six months and five years after surgery.

According to the study results, removing the wisdom teeth had no negative effect on PPD changes of nearby second molars after as many as five years. PPD reduced significantly, and CAL changes yielded similar results, indicating less gum disease. In addition, among those with completely bony unerupted wisdom teeth — which remain embedded in the jawbone with no space for the teeth to erupt — no deterioration was found in PPD and CAL.

“These findings confirm the attitude that preventive surgical M3 (third molar) removal does not cause additional damage to the neighboring M2 (second molars),” researchers wrote.

However, researchers noted preventive removal of wisdom teeth for orthodontic reasons should be decided while considering potential risks, such as nerve damage. Other risks include fractures, infections and pain. Deterioration of the gums of the nearby second molars helps determine whether to remove wisdom teeth, the study states.

The authors of “Five-Years Periodontal Outcomes of Early Removal of Unerupted Third Molars Referred for Orthodontic Purposes” are Hari Petsos, DMD, from private practice; Johann Wolfgang, Goethe-University Frankfurt in Frankfurt/Main, Germany; Janine Fleige; Jorg Korte, DDS, MD; Raphael Borchard, DDS, DMD, from private practice; Peter Eickholz, DMD, from Johann Wolfgang Goethe-University Frankfurt; and Thomas Hoffmann, DMD, from Dresden International University in Dresden, Germany.

The full article can be accessed at JOMS.org/article/S0278-2391(20)31403-8/fulltext.

About JOMS

The Journal of Oral and Maxillofacial Surgery is published by the American Association of Oral and Maxillofacial Surgeons to present to the dental and medical communities comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral and head and neck cancer, jaw reconstruction, anesthesia and analgesia. The journal also includes specifics on new instruments and diagnostic equipment, and modern therapeutic drugs and devices.

(Source: Journal of Oral and Maxillofacial Surgery)

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