Composite bone graft for treatment of osseous defects after surgical removal of impacted third and second molars: case report and review of the literature

The aim of this case report was to evaluate the clinical and radiographic measurements of mandibular first molar bone support after mandibular third and second molar extraction and immediate augmentation of the extraction site with a combined autogenous bone graft with Bio-Oss materials. A pyramidal full-thickness mucoperiosteal flap with 1 distal releasing incision was used for removal of impacted third and second molars. During the procedure, autogenous bone graft was collected with a bone trap and then combined with Bio-Oss materials. The osseous defects distal to first molar and extraction site was filled with the composite bone graft and covered with Bio-Gide membrane. After 1 year, there was a successful defect regression and gain of bone and clinical attachment level. Moreover, there was a reduction of probing pocket depth and gingival inflammation. From the results of this study, it can be concluded that grafting of osseous defects and extraction site with autogenous bone graft combined with Bio-Oss materials will predictably result in a decreased risk of developing a periodontal defect on the distal aspect of mandibular first molar.