Periodontal Complications

Removal of wisdom teeth is often carried out to preserve gum / periodontal health or, in some situations, to treat existing gum disease-pyorrhoea / periodontitis. With a partially impacted lower wisdom tooth, there is already a periodontal pocket on the mesial aspect of the wisdom tooth as well as a bony / osseous defect in the bone on the distal root of the second molar. This situation can, under certain circumstances, progress to rapid periodontal destruction.

Post-operative measurements show lower bone levels and deeper pocket depth than desirable.

Some studies have grouped patients into treatment groups according to age. It is suggested that patients < 19 years, between 20 - 35 years, > 35 years may have different periodontal healing potentials following lower third molar removal.

In most young patients (< 19 years), bone height after wisdom tooth removal appears similar to the pre-operative level. In fact, some studies even show a gain in bone level following surgery. If the bone level distal to the second molar is compromised before wisdom tooth removal, it normally remains below the normal level post-operatively. The greatest bone defects occur in older patients (> 35 years), in whom the wisdom teeth have already resorbed part of the second molar. Periodontal pocket depth appears to be the same post-operatively as pre-operatively and in older patients, pocket depth may even increase following removal of the wisdom tooth.

In younger patients, however, there appears to be no adverse effect on pocket depth. In younger patients, reduction in pocket depth can occur for up to 4 years following surgery though this benefit may not occur in older patients.