Bone Height and Extractions Study

King's College London

Status

Unknown

Conditions

Periodontal Attachment Loss

Periodontal Pocket

Alveolar Bone Loss

Treatments

Procedure: Third molar surgery

Study type

Interventional

Funder types

Other

Identifiers

NCT03909568

249253

Details and patient eligibility

About

A coronectomy is often chosen over complete extraction of a lower third molar when the tooth appears to be in close proximity to the inferior dental (ID) canal, as assessed on a plain radiograph or a cone beam computer tomograph (CBCT). Following a coronectomy, the roots of the third molar may migrate in a coronal direction. This effect, along with the bone-preserving technique of a coronectomy over extraction, may provide increased bone height distal to the lower second molars, when compared to extraction. Partially erupted lower third molars, specifically those with mesio-angular impactions, are commonly associated with reduced bone height distal to lower second molars, and cause damage to the periodontal support of these neighboring teeth. It is assumed that maintenance of the impacted third molars or extraction of these teeth may compromise the periodontal status of the lower second molars. This study will investigate if coronectomy improves the bone levels, and therefore the periodontal status, of lower second molars, and may propose an indication for a coronectomy regardless of the proximity of the tooth to the ID canal.

Coronectomies were first proposed as a treatment option just over thirty years ago, but there are very few long-term studies on the procedure reported in the literature. To the best of the investigator's knowledge, this will be the first randomised controlled trial comparing the bone height distal to the lower second molar following a coronectomy or extraction of the lower third molar.

Enrollment

50 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patients requiring extraction of both lower third molars
Both lower third molars to have mesio-angular impa
ctions, as assessed by location of the contact point between the crown of the third molar and the cemento-enamel junction (CEJ) of the second molar and the angulation of the third molar
Both lower third molars must lie above or clear of the ID canal as assessed on a plain radiograph or CBCT
Presence of lower second molars
Patients must be ≥18yrs old
Patients willing to attend follow up appointments

Exclusion criteria

Lower third molars with caries, periapical pathology or associated lesions such as cysts
Patients who are immunocompromised, have a history of or due to have head and neck radiotherapy, chemotherapy, have previously been given or due to start intravenous bisphosphonates
Smokers (>5 cigarettes/day)
Patients involved in current research or have recently been involved with research prior to recruitment