Skip to main content
Top
Published in: Journal of Maxillofacial and Oral Surgery 3/2012

01-09-2012 | Original paper

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

Authors: Anisha Maria, Murtuza Malik, Parag Virang

Published in: Journal of Maxillofacial and Oral Surgery | Issue 3/2012

Login to get access

Abstract

Aims and Objectives

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.

Materials and Methods

60 patients (37 females, 23 males; age range 18–40 years) 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.

Results

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.

Conclusion

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.
Literature
1.
go back to reference Curran JB, Kennett S, Young AR (1974) An assessment of the use of prophylactic antibiotic in third molar surgery. Int J Oral Surg 3:1–6PubMedCrossRef Curran JB, Kennett S, Young AR (1974) An assessment of the use of prophylactic antibiotic in third molar surgery. Int J Oral Surg 3:1–6PubMedCrossRef
2.
go back to reference MacGregor AJ, Hutchinson D (1975) The effect of sulfonamides on pain and swelling following removal of ectopic third molars. Int J Oral Surg 4:184–190PubMedCrossRef MacGregor AJ, Hutchinson D (1975) The effect of sulfonamides on pain and swelling following removal of ectopic third molars. Int J Oral Surg 4:184–190PubMedCrossRef
3.
go back to reference Petersen JK (1975) Anti-inflammatory and analgetic effects of indomethacin following removal of impacted mandibular third molars. Int J Oral Surg 4:267–276PubMedCrossRef Petersen JK (1975) Anti-inflammatory and analgetic effects of indomethacin following removal of impacted mandibular third molars. Int J Oral Surg 4:267–276PubMedCrossRef
4.
go back to reference Svenn K, Gilhuus-Moe O (1975) Paracetamol/Codeine in relieving pain following removal of impacted mandibular third molars. Int J Oral Surg 4:258–266CrossRef Svenn K, Gilhuus-Moe O (1975) Paracetamol/Codeine in relieving pain following removal of impacted mandibular third molars. Int J Oral Surg 4:258–266CrossRef
5.
go back to reference MacGregor AJ, Addy A (1980) Value of penicillin in the prevention of pain, swelling and trismus following the removal of ectopic mandibular third molars. Int J Oral Surg 9:166–172PubMedCrossRef MacGregor AJ, Addy A (1980) Value of penicillin in the prevention of pain, swelling and trismus following the removal of ectopic mandibular third molars. Int J Oral Surg 9:166–172PubMedCrossRef
6.
go back to reference Troullos ES, Hargreaves KM, Butler DP, Dionne RA (1990) Comparison of nonsteroidal anti-inflammatory drugs, ibuprofen and flurbiprofen, with methylprednisolone and placebo for acute pain, swelling and trismus. J Oral Maxillofac Surg 48:945–952PubMedCrossRef Troullos ES, Hargreaves KM, Butler DP, Dionne RA (1990) Comparison of nonsteroidal anti-inflammatory drugs, ibuprofen and flurbiprofen, with methylprednisolone and placebo for acute pain, swelling and trismus. J Oral Maxillofac Surg 48:945–952PubMedCrossRef
7.
go back to reference Schultze-Mosgau S, Schmelzeisen R, Frolich JC, Schmele H (1995) Use of ibuprofen and methylprednisolone for prevention of pain and swelling after removal of impacted third molars. J Oral Maxillofac Surg 53:2–7PubMedCrossRef Schultze-Mosgau S, Schmelzeisen R, Frolich JC, Schmele H (1995) Use of ibuprofen and methylprednisolone for prevention of pain and swelling after removal of impacted third molars. J Oral Maxillofac Surg 53:2–7PubMedCrossRef
8.
go back to reference Nordenram A, Sydnes G, Odegaard J (1973) Neomycin-bacitracin cones in impacted third molar sockets. Int J Oral Surg 2:279–283PubMedCrossRef Nordenram A, Sydnes G, Odegaard J (1973) Neomycin-bacitracin cones in impacted third molar sockets. Int J Oral Surg 2:279–283PubMedCrossRef
9.
go back to reference NzubeChukwuneke F, Oji C, Saheeb DB (2008) A comparative study of the effect of using a rubber drain on postoperative discomfort following lower third molar surgery. Int J Oral Maxillofac Surg 37:341–344CrossRef NzubeChukwuneke F, Oji C, Saheeb DB (2008) A comparative study of the effect of using a rubber drain on postoperative discomfort following lower third molar surgery. Int J Oral Maxillofac Surg 37:341–344CrossRef
10.
go back to reference de Brabander EC, Cattaneo G (1988) Effect of surgical drain together with a secondary closure technique on postoperative trismus, swelling and pain after mandibular third molar surgery. Int J Oral Maxillofac Surg 17:119–121PubMedCrossRef de Brabander EC, Cattaneo G (1988) Effect of surgical drain together with a secondary closure technique on postoperative trismus, swelling and pain after mandibular third molar surgery. Int J Oral Maxillofac Surg 17:119–121PubMedCrossRef
11.
go back to reference Dubois DD, Pizer ME, Chinnis RJ (1982) Comparison of primary and secondary closure techniques after removal of impacted mandibular third molars. J Oral Maxillofac Surg 40:631–634PubMedCrossRef Dubois DD, Pizer ME, Chinnis RJ (1982) Comparison of primary and secondary closure techniques after removal of impacted mandibular third molars. J Oral Maxillofac Surg 40:631–634PubMedCrossRef
12.
go back to reference Pasqualini D, Cocero N, Castella A, Mela L, Bracco P (2005) Primary and secondary closure of the surgical wound after removal of impacted mandibular third molars: a comparative study. Int J Oral Maxillofac Surg 34:52–57PubMedCrossRef Pasqualini D, Cocero N, Castella A, Mela L, Bracco P (2005) Primary and secondary closure of the surgical wound after removal of impacted mandibular third molars: a comparative study. Int J Oral Maxillofac Surg 34:52–57PubMedCrossRef
13.
go back to reference Shugars DA, Benson K, White RP, Simpson KN, Bader JD (1996) Developing a measure of patient perceptions of short term outcomes of third molar surgery. J Oral Maxillofac Surg 54:1402–1408PubMedCrossRef Shugars DA, Benson K, White RP, Simpson KN, Bader JD (1996) Developing a measure of patient perceptions of short term outcomes of third molar surgery. J Oral Maxillofac Surg 54:1402–1408PubMedCrossRef
14.
go back to reference Ruta DA, Bissias E, ogston S, Ogdan GR (2000) Assessing health outcomes after extraction of third molars: the postoperative symptom severity scale. Br J Oral Maxillofac Surg 38:480–487PubMedCrossRef Ruta DA, Bissias E, ogston S, Ogdan GR (2000) Assessing health outcomes after extraction of third molars: the postoperative symptom severity scale. Br J Oral Maxillofac Surg 38:480–487PubMedCrossRef
15.
go back to reference Holland CS (1979) The development of a method of assessing swelling following third molar surgery. Br J Oral Surg 17(2):104–114PubMedCrossRef Holland CS (1979) The development of a method of assessing swelling following third molar surgery. Br J Oral Surg 17(2):104–114PubMedCrossRef
16.
go back to reference Mohan H (2005) Healing of tissues. In: Mohan H (ed) Essential pathology for dental students, 3rd edn. Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, pp 135–144CrossRef Mohan H (2005) Healing of tissues. In: Mohan H (ed) Essential pathology for dental students, 3rd edn. Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, pp 135–144CrossRef
17.
go back to reference Sivapathasundharam B (2008) Healing of oral wounds. In: Shafer G, Hine MH, Levy BM (eds) Shafer’s textbook of oral pathology, 5th edn. Elsevier a Division of Reed Elsevier India Private Limited, Delhi, pp 816–842 Sivapathasundharam B (2008) Healing of oral wounds. In: Shafer G, Hine MH, Levy BM (eds) Shafer’s textbook of oral pathology, 5th edn. Elsevier a Division of Reed Elsevier India Private Limited, Delhi, pp 816–842
18.
go back to reference Rakprasitkul S, Pairuchvej V (1997) Mandibular third molar surgery with primary closure and tube drain. Int J Oral Maxillofac Surg 26:187–190PubMedCrossRef Rakprasitkul S, Pairuchvej V (1997) Mandibular third molar surgery with primary closure and tube drain. Int J Oral Maxillofac Surg 26:187–190PubMedCrossRef
19.
go back to reference Van Gool AV, Ten Bosch JJ, Boering G (1975) A photographic method of assessing swelling following third molar removal. Int J Oral Surg 4:121–129PubMedCrossRef Van Gool AV, Ten Bosch JJ, Boering G (1975) A photographic method of assessing swelling following third molar removal. Int J Oral Surg 4:121–129PubMedCrossRef
20.
go back to reference Ucok C (1997) Stereophotogrammetric assessment of the effect of tenoxicam on facial swelling subsequent to third molar surgery. Int J Oral Maxillofac Surg 26:380–382PubMedCrossRef Ucok C (1997) Stereophotogrammetric assessment of the effect of tenoxicam on facial swelling subsequent to third molar surgery. Int J Oral Maxillofac Surg 26:380–382PubMedCrossRef
21.
go back to reference Henrikson PA, Thilander H, Wahlander LA (1985) Voltaren as an analgesic after surgical removal of a lower wisdom tooth. Int J Oral Surg 14:333–338PubMedCrossRef Henrikson PA, Thilander H, Wahlander LA (1985) Voltaren as an analgesic after surgical removal of a lower wisdom tooth. Int J Oral Surg 14:333–338PubMedCrossRef
22.
go back to reference Holland CS, Hindle MO (1984) The influence of closure or dressing of third molar sockets on postoperative swelling and pain. Br J Oral Maxillofac Surg 22:65–71PubMedCrossRef Holland CS, Hindle MO (1984) The influence of closure or dressing of third molar sockets on postoperative swelling and pain. Br J Oral Maxillofac Surg 22:65–71PubMedCrossRef
23.
go back to reference Waite PD, Cherala S (2006) Surgical outcomes for suture-less surgery in 366 impacted third molar patients. J Oral Maxillofac Surg 64:669–673PubMedCrossRef Waite PD, Cherala S (2006) Surgical outcomes for suture-less surgery in 366 impacted third molar patients. J Oral Maxillofac Surg 64:669–673PubMedCrossRef
Metadata
Title
Comparison of Primary and Secondary Closure of the Surgical Wound After Removal of Impacted Mandibular Third Molars
Authors
Anisha Maria
Murtuza Malik
Parag Virang
Publication date
01-09-2012
Publisher
Springer-Verlag
Published in
Journal of Maxillofacial and Oral Surgery / Issue 3/2012
Print ISSN: 0972-8279
Electronic ISSN: 0974-942X
DOI
https://doi.org/10.1007/s12663-011-0287-9

Other articles of this Issue 3/2012

Journal of Maxillofacial and Oral Surgery 3/2012 Go to the issue