Verify if Amelogenins Had Some Benefits in Improving Lower 2nd Molar Periodontal Healing After 3rd Molar Extraction

Usefulness of Amelogenins in the Treatment of Periodontal Defects on the Distal Surface of the Lower Second Molar After Adjacent Third Molar Extraction: a Pilot Study

Background: Prevention of periodontal defects after the extraction of lower third molars remains a challenge. Various methods have been proposed in the literature, but there are no studies which evaluated the effectiveness of amelogenins.

Methods: A single-blind split-mouth randomized controlled clinical trial (RCT) was performed on 5 patients to verify if amelogenins had some benefits in improving lower second molar periodontal healing after adjacent third molar extraction. A PPD ≥ 8 mm associated with a radiographic bone defect of at least 5 mm were the main inclusion criteria.

Inclusion Criteria:

• Patients aged < 27, for which the extraction of both lower third molars was indicated
• Bilateral total (bone or osteo-mucosal) third molar impaction
• Bilateral bone defect ≥ 5mm distal to the lower second molars, evaluated on pre- operative periapical radiographs performed with Rinn's film holders
• PPD ≥ 8mm distal to the second lower molars, in at least one of the following probing sites: buccal, disto-buccal, disto-central, disto-lingual
• Intra-operative integrity of both third molar buccal and lingual alveolar cortices

Exclusion Criteria:

• Smoking habit
• Systemic disorders with serious immunologic impairment
• Taking cortisone or other drugs that might interfere with healing process
• Allergy to penicillins
• Previous periodontal treatment
• Less than 2 mm of adherent gingiva at second molar level
• Second molars with a prosthetic crown
• Previous endodontic treatment of second molars
• Furcation involvement of the second molars