Buccal window approach: A favorable technique for preserving periodontium in impacted third molar surgery

The present study assessed the probing depth of the second molar distal aspect after the surgical removal of adjacent mandibular impacted third molars using osteotomy by a buccal window and routine crestal flaps.

In this double-blind, randomized clinical trial, 16 candidates for the surgical removal of bilateral mandibular third molars were selected, and each side's tooth was assigned to a different osteotomy group. The surgery was performed using a sulcular flap and a distal extension for one group, while the osteotomy was performed using the buccal window technique. The pocket probing depth of the adjacent second molars was calculated before and three months after the surgical removal. The data of both groups were statistically analyzed using normality and t-tests in the SPSS software. Statistical significance was set at P<0.05.

At three months postoperatively, significant differences were found between the two groups regarding pocket probing depth at mesiobuccal (5.23±1.12 mm in the crestal osteotomy and 4.03±1.16 mm in the buccal window osteotomy; P<0.006), mid-distal (5.77±1.08 mm in the crestal osteotomy and 4.25±1.35 mm in the buccal window osteotomy; P<0.002), and distolingual aspects (5.46±1.34 mm in the crestal osteotomy and 3.96±1.11 mm in the crestal osteotomy; P<0.002) of the adjacent second molars. The mean pocket probing depth of the mid-distal area was significantly lower in the buccal window osteotomy.

According to the results, this technique can be used as an alternative to crestal osteotomy in level C impactions and Cl I and Cl II impactions regarding position towards the anterior edges of the mandibular ramus.