Comparison of complications following primary and secondary wound closure after surgical extraction of impacted mandibular third molars among patients visiting a tertiary care center, Gandaki Province

Abstract

Introduction: The surgical extraction of impacted mandibular third molars is often associated with post-operative complications and is affected by degree of impaction, surgical technique, operator skill and wound closure method. The purpose of this study was to compare the effect of primary and secondary wound closure after surgical removal of impacted mandibular third molars.

Methods: A hospital-based cross-sectional study was conducted in 40 patients and were divided into two groups using lottery method of 20 each. Twenty patients underwent primary closure of the wound while other 20 underwent secondary closure. Post-operative pain, swelling and trismus were evaluated on third and seventh day of extraction.

Results: The mean age of the patient was 31.57 years (ranging from 28 to 42). The mean VAS score for pain was more on third day in patients with primary closure (2.70±0.733). This finding was statistically significant (p<0.001). On seventh day, it was more for the patients with primary closure but was not statistically significant. The mean VAS score for swelling was more on third day in patients with primary closure (3.70±0.73). Furthermore, it was same on seventh day for both groups (0.50±0.51). Both of these findings were not statistically significant. The secondary closure group had a higher mean mouth opening than the primary closure group on third day (40.35±0.93) which was statistically significant (p<0.001). In seventh day, both groups had the same mean mouth opening (41.20±0.89) which was not statistically significant.

Conclusions: The secondary wound closure technique had a significant advantage over primary wound closure concerning pain, swelling and trismus.