Evaluation of Two Different Grafting Techniques After Mandibular Impacted Third Molar Surgery

Study Overview
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Brief Summary
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This study evaluates the effectiveness of using Mineralized Plasmatic Matrix and β-tricalcium phosphate that placed to extraction socket as a graft material in terms of periodontal damage occurred in the distal aspect of the second molar after mandibular impacted third molar surgery.

Official Title
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Evaluation of the Effectiveness of the Mineralized Plasmatic Matrix and Tricalcium Phosphate Graft Application After Mandibular Impacted Third Molar Surgery in Terms of Periodontal and Osseous Healing Distal to the Second Molar

Conditions
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Periodontal Pocket, Impacted Third Molar Tooth, Impacted Teeth With Abnormal Position

Intervention / Treatment
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* Procedure: Impacted third molar surgery
* Procedure: Application of mineralised plasmatic matrix
* Procedure: Application of β-tricalcium phosphate


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Medically healthy. Periodontally healthy patients. Patients with mesioangular or horizontal impacted teeth that will cause periodontal damage at the distal part of the second molar after surgery. Exclusion Criteria: Crowns on second molar teeth. Poor oral hygiene. Patients with a systemic disease affecting periodontal healing. Pregnancy or lactation period. Patients undergoing orthodontic treatment. Smokers. The cases where the buccal or lingual cortical bone didn't remain intact following the extraction were also excluded.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mineralised Plasmatic Matrix Group<br>Mineralized Plasmatic Matrix (MPM) is a product of mixing of two phases: the mineral phase and the plasma phase. After centrifugation, the white blood cells are recovered and mixed with the mineral phase of bone graft that can be autogenic, allogeneic bone, or a bone substitute like Xenogeneic Bone Synthetic. We will use Beta-tricalcium phosphate as a graft material. The result of this mixture is a homogeneous single component, which is compact and stable, containing the graft, the dense fibrin network, and the promoting healing. And then we are planning to place MPM material to extraction socket of impacted third molar tooth to improve periodontal healing at the distal aspect of second molar tooth. Additional after MPM places to extraction socket, Once the MPM has been placed, it will be covered with a Platelet Rich Fibrin (PRF) membrane and sutured as a primer. | Procedure: Impacted third molar surgery<br>* Under local anesthesia, flap will be raised and mesioangular or horizontal impacted third molar tooth will be removed with routine technique. And then extraction socket will be irrigated with salin and will be primarily closed.<br>Procedure: Application of mineralised plasmatic matrix<br>* After extraction of impacted third molar tooth, Mineralized Plasmatic Matrix will be placed to the socket as a graft material and will be covered with Platelet Rich Fibrin membrane. Then wound will be primarily closed.<br>* Other names: Application platelet rich fibrin membrane;|
| Experimental: Beta-tricalcium phosphate Group<br>Beta-tricalcium phosphate graft will place in the extraction socket and cover with a PRF membrane. | Procedure: Impacted third molar surgery<br>* Under local anesthesia, flap will be raised and mesioangular or horizontal impacted third molar tooth will be removed with routine technique. And then extraction socket will be irrigated with salin and will be primarily closed.<br>Procedure: Application of β-tricalcium phosphate<br>* After extraction of impacted third molar tooth, β-tricalcium phosphate will be placed to the socket as a graft material and will be covered with Platelet Rich Fibrin membrane. Then wound will be primarily closed.<br>* Other names: Application platelet rich fibrin membrane;|
| Active Comparator: Control Group<br>In the control group, after removal of impacted third molar tooth no material will be placed on the extraction socket. Only the extraction socket was primarily closed with non-resorbable sutures. | Procedure: Impacted third molar surgery<br>* Under local anesthesia, flap will be raised and mesioangular or horizontal impacted third molar tooth will be removed with routine technique. And then extraction socket will be irrigated with salin and will be primarily closed.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Periodontal pocket depth | Initial periodontal pocket depth measurement at the distal aspect of second molar tooth before extraction. | At 0 day | 
| Alveolar bone level | Initial bone level measurement at the distal aspect of second molar tooth before extraction. | At 0 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Periodontal pocket depth | Secondary measurement of periodontal pocket depth after extraction | At 6th month | 
| Alveolar bone level | Secondary measurement of bone level after extraction | At 6th month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Mineralized Plasmatic Matrix, Beta-tricalcium phosphate