The effect of alloplastic bone graft and absorbable gelatin sponge in prevention of periodontal defects on the distal aspect of mandibular second molars, after surgical removal of impacted mandibular third molar: a comparative prospective study.
OBJECTIVE
Recent studies claim that haemostatic agents can be used as bone graft substitutes. The aim of this study was to compare the efficacy of alloplastic bone graft with absorbable gelatin sponge in prevention of periodontal defects distal to mandibular second molar after the surgical removal of impacted mandibular third molars.


METHODS
A prospective, randomized, single-blind split-mouth study was designed. The study consisted of 25 patients requiring surgical removal of bilateral impacted mandibular 3rd molars. The surgical sites were randomly divided into 2 groups: group I: G-graft (hydroxyapatite + collagen, study group) and group II: Abgel (absorbable gelatin sponge, control group). Patients were recalled on lst and 7th postoperative days and 3rd and 6th postoperative months. Probing depth, alveolar bone levels and soft tissue wound healing were evaluated. Paired t test was used to compare pre and post-operative alveolar bone levels and probing depth (PD). Wilcoxon signed ranks test was used to compare the wound healing.


RESULTS
The soft tissue wound healing, PD and the distance between the cemento-enamel junction on the distal aspect of mandibular second molar (point A) and the alveolar crest on the distal aspect of the same tooth (point B) were significantly higher in group I as compared to group II.


CONCLUSIONS
This study reveals an increase in the alveolar bone level, improvement of PD and better wound healing in group I. Group II subjects required longer healing time than the normal. The authors disagree the claim that the haemostatic agents can be used as bone graft substitutes. However, long-term, multicenter, randomized controlled clinical trials are required.
Department of Oral and Maxillofacial Surgery, Dr. DY Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, 411018 India.
Manju
M
Singh
Department of Oral and Maxillofacial Surgery, Dr. DY Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, 411018 India.
Kalyani
K
Bhate
Department of Oral and Maxillofacial Surgery, Dr. DY Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, 411018 India.
Deepak
D
Kulkarni
Department of Oral and Maxillofacial Surgery, Dr. DY Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune, 411018 India.
S N
SN
Santhosh Kumar
Department of Periodontics, Dr. DY. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, 411018 Maharashtra India.
Rahul
R
Kathariya
Collagen; Hemostatics; Hydroxyapatite-beta tricalcium phosphate; Impacted teeth