IS BONE GRAFTING NEEDED AFTER THIRD MOLAR (WISDOM TOOTH) EXTRACTIONS?
First off, as I have blogged before, get wisdom teeth out at an early age – about 15 years old – and you avoid 99% of the problems that tend to occur including the problems talked about in this article. But assuming that you are older and still have your wisdom teeth, as a rule, the earlier you have them out the better.
I am addressing an article that proposes grafting of bone defects on the back of second molar teeth associated with impacted third molar teeth. (Compendium February 2020, Volume 41, Number 2, Pgs. 76-82).
For most patients, it is best to perform as non-traumatic an extraction as possible, allow for natural healing, and then address periodontal defects as a secondary surgery. Typically, the problems necessitating removal of the third molars – such as infection and/or inflammation – adversely affect the outcomes of any grafting procedures that may be done. As a rule, we have good healing after our third molar removal procedures. We use careful techniques, we debride, clean and irrigate the surgical site, and suture the tissues for best outcomes. This results in nice healing contours and good periodontal health for most patients. If there is existing disease such as infection or periodontal bone loss, we address those types of concerns at the time of surgery as we can. If there are healing problems such as a bone defect, we would address that once we have a clear, healed site with good tissue coverage. The main exception for me is when we are dealing with a large lesion defect in which case bone grafting is often considered.
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