Comparative study of primary and secondary closure of the surgical wound after removal of impacted mandibular third molars

Oral Maxillofac Surg. 2018 Sep;22(3):261-266. doi: 10.1007/s10006-018-0696-8. Epub 2018 May 23.

Abstract

Aim: Aim of the study is to compare the primary and secondary healing after surgical removal of impacted mandibular third molars, in terms of swelling, severity of pain, trismus, and periodontal healing between two types of closure.

Materials and methods: A total of 60 patients, divided into two groups randomly: group A, with 30 patients in which primary closure was done; group B, with 30 patients in which secondary closure was done. A comparison between two groups was done in terms of postoperative pain, swelling, trismus at first, third, and seventh postoperative days, and periodontal healing near adjacent second molar after 6 months.

Results: The swelling and pain in group A were greater than that in group B, with a statistically significant difference (p < 0.05). Mouth opening is greater in group B compared to group A. There is no significant difference in periodontal healing in between two groups after 6 months. Complication like alveolar osteitis was noted in 1 patient (3.3%) in group B.

Conclusion: We conclude that secondary closure was better than primary closure in terms of postoperative pain, swelling, and trismus. Irrespective of any closure technique, there is no difference in terms of periodontal healing.

Keywords: Impaction; Periodontal healing; Primary healing; Secondary healing; Trismus; VAS.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Edema / prevention & control
  • Female
  • Humans
  • Male
  • Middle Aged
  • Molar, Third / pathology
  • Molar, Third / surgery*
  • Pain Measurement
  • Pain, Postoperative / prevention & control
  • Postoperative Complications / prevention & control*
  • Suture Techniques / instrumentation*
  • Tooth Extraction / methods*
  • Tooth, Impacted / pathology
  • Tooth, Impacted / surgery*
  • Treatment Outcome
  • Trismus / prevention & control
  • Wound Closure Techniques / instrumentation*
  • Wound Healing