Prognostic Impact of Non-Impacted Third Molar Extraction on Non-Surgical Periodontal Therapy for Adjacent Second Molars: A Prospective Split-Mouth Study

Aims

To compare the outcomes of non-surgical periodontal therapy (NSPT) alone and NSPT plus adjacent non-impacted third molar (N-M3) removal on second molars (M2s).

Materials and Methods

In this prospective split-mouth study, 40 patients with periodontitis who had N-M3s on both sides of the same jaw were enrolled. For each patient, a full-mouth NSPT was performed, with one N-M3 extracted (N-M3−) and the other N-M3 retained (N-M3+). Periodontal clinical parameters, gingival crevicular fluid (GCF) and subgingival plaque samples were measured/collected before (T0), 3 months after (T1) and 6 months after (T2) the treatment.

Results

All M2s showed improved probing depth after treatment. At T1 and T2, M2s in the N-M3− group yielded better outcomes in periodontal clinical parameters than the N-M3+ group, along with a significant decrease in the abundance of periodontal pathogens such as Porphyromonas gingivalis , Prevotella nigrescens and Fusobacterium nucleatum in subgingival plaque. At T2, the M2s in the N-M3− group had significantly lower GCF volume and higher interleukin-10 levels than those in the N-M3+ group.

Conclusion

Over the 6-month observation period, removal of adjacent N-M3s enhanced the outcome of NSPT for second molars, as demonstrated clinically, immunologically and microbiologically.

Trial Registration: Chinese Clinical Trail Registry (identification number: ChiCTR2300070343). https://www.chictr.org.cn/showproj.html?proj=194830 Date of Registration: April 10th, 2023