Distal Molar Surgery

Periodontitis is a chronic inflammation involving tooth investing structures.1 It causes irreversible bone and attachment loss. Very often third molar impaction leads to various complications adversely influencing the entire periodontal status.2 Therefore disimpaction surgery is one of the most commonly performed procedures. Extraction of an impacted molar tends to initiate localized periodontal pockets distally to an adjacent molars.3 This favours colonization of the subgingival microbiota, due to the difficulties associated with hygiene, and leads to the appearance of progressive bone loss into an well-defined angular defect.4 The primary goal of periodontal therapy is aimed at prevention, slowing or arresting disease progression. 5 Gingivectomy is the first choice of treatment in distal pocket due bulbous fibrous tissue. It can only be the choice of treatment when adequate amount of keratinized tissue is present at the site. Nevertheless, many times inadequate keratinized tissue or an angular bony defect has been diagnosed. Then bulbous tissue is preferably reduced in bulk and not be removed completely by the distal molar surgery. 6 The technique aids in pocket management. Apart, it also facilitates access to the osseous defect. It also secures the sufficient amounts of gingival tissue to achieve coverage.