EVALUATION OF THE PERIODONTAL STATUS OF THE SECOND MOLAR AFTER THE SURGICAL REMOVAL OF THE MANDIBULAR IMPACTED THIRD MOLAR – A PROSPECTIVE STUDY

Background: Impacted mandibular third molars are commonly associated with periodontal changes affecting the distal surface of the adjacent mandibular second molar because of plaque retention, inflammation, and difficulty in maintaining oral hygiene. Surgical removal may influence the periodontal status of the second molar.
Methods: This prospective observational study included 100 patients with mandibular impacted third molars. Periodontal probing depth was recorded at mesiobuccal, distobuccal, mesiolingual, and distolingual sites of the adjacent second molar. Clinical attachment level and radiographic alveolar bone level were also assessed. Measurements were obtained preoperatively, on postoperative day 7, and at 3 months. Data were analyzed using repeated-measures analysis of variance with Bonferroni post-hoc testing and one-way analysis of variance with Tukey HSD testing for subgroup comparisons.
Results: Mesiobuccal and mesiolingual probing depths did not change significantly over time. Significant overall changes were observed for distobuccal probing depth (p=0.009), distolingual probing depth (p=0.023), clinical attachment level (p<0.001), and alveolar bone level (p<0.001). Distobuccal probing depth improved significantly between day 7 and 3 months (p=0.048). Deeper Position C impactions showed significantly worse alveolar bone levels than shallower positions, including mean differences of 2.56 mm for mesioangular C versus A and 2.29 mm for vertical C versus A (both p<0.001).
Conclusion: Surgical removal of impacted mandibular third molars was associated with overall favorable periodontal changes at the adjacent second molar, particularly at distal sites. Greater impaction depth was associated with greater periodontal compromise.