Penarrocha M, Gomez D, Garcia B, Bagan JV. Treatment of bone defects produced by lower molar extraction using ultrasound harvested autologous bone grafts. J Oral Maxillofac Surg. 2008 Jan;66(1):189-92.
Periodontal pockets distal to the second molar in relation to a lower third molar that fails to erupt normally is a common finding. Surgical extraction of the third molar may also cause or worsen such a periodontal impairment of the second molar.1,2 A periodontal pocket distal to the second molar leads to increased dental sensitivity, difficulty in maintaining proper oral hygiene in the zone, and gradual loss of bone support distal to the second molar.1 The literature describes different techniques for avoiding such bone defects, including curettage and root treatments, 3 the use of demineralized bone to fill the postextraction zone,4 and guided tissue regeneration. 5,6 Piezosurgery ultrasound instruments allow exact, clean, and smooth-cut geometries during surgery, with negligible differences in time required for surgery versus conventional drill instruments.7 A surgical treatment with an ultrasound instrument is described for bone regeneration of periodontal defects distal to the second mandibular molar after third molar removal, involving the use of an autologous bone graft block obtained from the retromolar zone.