Abstract
BackgroundCollagen membranes have some benefits include promoting wound healing through isolation, clot stabilization, wound stability, and hemostasis, enhancing primary wound coverage through its chemotactic ability to attract fibroblasts, and augmenting flap thickness by providing a collagenous scaffold. The purpose of this study was to compare primary and secondary healing and collagen membrane-based primary healing after surgical removal of partial impacted mandibular third molars, evaluating the incidence of postoperative complications and analyzing the swelling, mouth opening, and pain.MethodsThis was a prospective, randomized controlled study. Patients were randomly assigned to three groups: the SC (Secondary closure) group, the PC (Primary closure) group, and the MBPC (membrane based primary closure) group. Data were collected on pain, mouth opening, swelling, and complications experienced by the patients.ResultsThere was no statistically significant difference between the groups for the pain (p > 0.05), relatively. The swelling recorded on postoperative days 2 and 7 was lower in the SC group than in the PC (p = 0.046 and 0.00) and in MBPC (p = 0.005 and 0.002) groups, respectively. Mouth opening showed a statistically significant difference between the three groups at day 2 (p = 0.00). Wound dehiscence was shown in 6 patients in the PC (20%) group and 2 patients in the MBPC (6.7%) group. Dry socket was observed 3 patients in the SC group (10%), 2 patients in the PC group (6.7%), and no dry socket in the MBPC group. No cases of infection or postoperative bleeding were encountered.ConclusionsThe secondary closure provides a marked advantage over the primary closure in terms of swelling and mouth opening. However, the absence of alveolitis in the primary closure using the collagen membrane and minimal wound dehiscence, suggests that membrane use may support primary healing in terms of wound healing.
Highlights
Collagen membranes have some benefits include promoting wound healing through isolation, clot stabilization, wound stability, and hemostasis, enhancing primary wound coverage through its chemotactic ability to attract fibroblasts, and augmenting flap thickness by providing a collagenous scaffold
Patients were randomly assigned to three groups: the SC (Secondary closure) group, involving partial closure of the extraction site to allow secondary healing; the PC (Primary closure) group, involving total closure of the extraction site by sliding the flap to allow primary healing; and the Membrane based primary closure (MBPC) group, involving total closure of the extraction site by sliding the flap and using a collagen membrane
These results show no statistically significant difference (p > 0.05) except operation time (p = 0.003) (Table 1)
Summary
Collagen membranes have some benefits include promoting wound healing through isolation, clot stabilization, wound stability, and hemostasis, enhancing primary wound coverage through its chemotactic ability to attract fibroblasts, and augmenting flap thickness by providing a collagenous scaffold. Many researchers have focused on factors affecting the postoperative complications associated with this surgery, investigating subjects, such as surgical techniques, drugs, and instruments, for minimizing these complications [4,5,6]. Wound closure is another subject associated with 3 M surgery, and two methods have been proposed: primary closure, in which the mucoperiosteal flap is complete and hermetically closed, and secondary closure, in which the mucoperiosteal flap is partially closed, leaving a gap created to allow healing of the wound area [1, 2]. New research is needed to make a clearer distinction
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