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Randomized controlled trial on the effectiveness of absorbable collagen sponge after extraction of impacted mandibular third molar: split-mouth design.

ABSTRACT: BACKGROUND:The purpose of this study was to compare the effectiveness of absorbable collagen sponge insertion in tooth extraction sites for socket healing of the impacted mandibular third molar. METHODS:Thirty-six patients with bilateral mandibular impacted third molars based on Pell-Gregory and Winter classification were included in this study. This study was a randomized clinical trial utilizing a split-mouth design with one side assigned as collagen sponge insertion and the other side assigned as the control. Post-operative clinical complications, periodontal integrities, and radiographic outcomes were assessed at 1, 2, and 14-weeks post operatively. RESULTS:Five patients were excluded during the follow-up period due to loss of follow-up. The study was conducted on 31 patients in total. The mean VAS score of collagen sponge insertion side at 1 week post operation was 1.42 ± 1.26, which was significantly lower than the control side (P < 0.05). The mean probing depth of collagen sponge insertion side at 2-week post operation was 5.55 ± 2.28 mm, which was significantly lower than the control side (7.13 ± 1.86; P < 0.05). Other various measurements including radiographic outcomes showed no significant group differences. CONCLUSIONS:Placement of collagen sponge after extraction of mandibular impacted third molar reduced early stage post-operative complications and enhanced initial healing of soft tissues and periodontal defects. TRIAL REGISTRATION:This study was retrospectively registered at the WHO ICTRP platform and Clinical Research Information Service, KCT0003363. Registered 21 Sep 2018.

SUBMITTER: Kim JW

PROVIDER: S-EPMC7079387 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Randomized controlled trial on the effectiveness of absorbable collagen sponge after extraction of impacted mandibular third molar: split-mouth design.

Kim Jin-Woo JW Seong Tae-Whan TW Cho Sura S Kim Sun-Jong SJ

BMC oral health 20200318 1

<h4>Background</h4>The purpose of this study was to compare the effectiveness of absorbable collagen sponge insertion in tooth extraction sites for socket healing of the impacted mandibular third molar.<h4>Methods</h4>Thirty-six patients with bilateral mandibular impacted third molars based on Pell-Gregory and Winter classification were included in this study. This study was a randomized clinical trial utilizing a split-mouth design with one side assigned as collagen sponge insertion and the oth ...[more]

PMID: 32183831

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Project description:BackgroundSince the discovery of adult mesenchymal stem cells extensive research has been conducted to determine their mechanisms of differentiation and effectiveness in cell therapy and regenerative medicine.Material and methodsTo assess the efficacy of autologous dental pulp mesenchymal stem cells delivered in a collagen matrix for post-extraction socket healing, a single-centre, double-blind, randomised, split-mouth, controlled clinical trial was performed. Both impacted mandibular third molars were extracted from 32 patients. Dental pulp was collected and dissociated; the resulting cell suspension, obtained by centrifugation, was incorporated into a resorbable collagen matrix and implanted in 32 experimental post-extraction sockets. Collagen matrices alone were implanted in 32 contralateral, control post-extraction sockets. Two neuroradiologists independently assessed the extent of bone repair at 6 months after the extractions. Computed tomography (CT, Philips Brilliance) and an advanced display platform (IntelliSpace Portal) was used to record extraction socket density, expressed as Hounsfield units (HU) and height (mm) of the distal interdental bone septum of the second molar. Measurements at 6 months post-extraction were compared with measurements obtained immediately after extraction. Data were analysed with the statistical program STATA 14.ResultsTwo patients dropped out of the study. The final sample consisted of 22 women and 8 men (mean age, 23 years; range: 18-30 years). Clinical, radiological, and surgical characteristics of impacted third molars of the control and experimental groups were homogeneous. Measurements obtained by the two neuroradiologists showed agreement. No significant differences were found in the extent of bone repair during analyses of density (p=0.4203 neuroradiologist 1; p=0.2525 neuroradiologist 2) or interdental septum height (p=0.2280 neuroradiologist 1; p=0.4784 neuroradiologist 2).ConclusionsIn our clinical trial, we were unable to demonstrate that autologous dental pulp mesenchymal stem cells reduce socket bone resorption after inferior third molar extraction.

Project description:BackgroundVarious injection methods have been used to improve the success rate of inferior alveolar nerve (IAN) block and reduce the pain and complications. But these methods also have their advantages and disadvantages. A modified 3-distal site anesthesia injection method proposed in 2015 was used clinically with satisfactory results at some dental clinics in China. This study aimed to determine the feasibility of this modified 3-distal site anesthesia injection method for extraction of an impacted mandibular third molar from an anatomical point of view.MethodsThree-dimensional (3D) reconstruction and analysis of the mandibles was performed using cone-beam computed tomography (CBCT) scanning to measure the simulated needle insertion depth, infiltration distance, and other important parameters. These parameters were compared with an actual depth of 20 mm and a theoretic infiltration distance of 10 mm. The main parameters were compared between males and females.ResultsSixty-three CBCT datasets were imported into Simplant OMS software for 3D reconstruction. The left simulated insertion depth did not differ from 20 mm, while right insertion depth was >20 mm (P<0.05). The bilateral infiltration distances were <10 mm (P<0.05) and articaine blocked the IAN. The widths of the mandibular rami were greater than the syringe length (21 mm), thus it was not possible for the syringe to reach the distal edge of the mandible. There was no difference in the simulated needle insertion depth and infiltration distance between the left and right (P>0.05). The bilateral simulated insertion depths, infiltration distances, widths of the mandibular rami, and height of the left mandibular foramen in females were less than in males (P<0.05), while there was no difference in the height of the right mandibular foramen and bilateral insertion angles (P>0.05).ConclusionsThe modified 3-distal site anesthesia injection method was shown to block the IAN based on anatomic evidence derived from 3D analysis on the measurements by CBCT.

Dataset Information

Randomized controlled trial on the effectiveness of absorbable collagen sponge after extraction of impacted mandibular third molar: split-mouth design.

Publications

Randomized controlled trial on the effectiveness of absorbable collagen sponge after extraction of impacted mandibular third molar: split-mouth design.

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