Comparison of Primary and Secondary Closure of the Surgical Wound After Removal of Impacted Mandibular Third Molars

Abstract

This comparative study compares the primary and secondary healing after surgical removal of impacted mandibular third molars, evaluating and monitoring the extent of swelling and severity of pain and trismus. 60 patients (37 females, 23 males; age range 18-40years) were included in the series. The patients were randomly subdivided into 2 groups of 30 each. All the patients were operated by the same operator under same clinical conditions. Group 1 had 30 patients who underwent primary closure. Group 2 had 30 patients who underwent secondary closure. Pain, swelling and trismus were evaluated for 1st, 3rd and 7th days after surgery with a VAS scale. An analysis of immediate findings showed that the patients with primary closure experienced significantly greater pain, swelling and trismus than that was experienced by patients with secondary closure. When the subsequent findings were analyzed there was statistically significant difference in pain, swelling and trismus experienced between both the groups. The findings of this study suggest that the procedure of choice after removal of impacted mandibular third molars is a secondary closure and healing by secondary intention. A secondary closure appears to minimize the postoperative edema, pain and trismus and thus contributes to enhanced patient comfort.