A technique to manage gingival complications of third molar surgery

Iatrogenic damage to the gingiva of the mandibular second molar is an often overlooked complication associated with surgery of impacted mandibular third molars. During impaction surgery, the peripheral gingival soft tissues may be damaged on flap elevation or destroyed during bone removal or tooth sectioning with rotary instruments. Loss of the often-thin band of keratinized gingiva of the second molar predisposes a patient to pain, plaque retention, inflammation, gingivitis, pocket formation, periodontitis, and alveolar bone loss. The surgically-induced bone defect associated with impaction removal exacerbates the aforementioned problems, which are difficult to treat with conventional techniques. This article attempts to address this issue and presents an new technique to manage such gingival complications.