Comparison Between Primary and Secondary Method of Closing Surgical Wound After Tooth Extraction: A Split-Mouth Study

Abstract

To compare and assess the primary and secondary closure techniques following extraction of impacted third molars for post-operative complications. Material and Methods: In total, 30 patients ranging between 18-30 years of age and of either sex who had bilaterally impacted mandibular third molars were randomly selected. Split mouth study method was used so that the participants served as their own control. Group 1 consisted of primary closure of left mandibular impacted third molars and Group 2 consisted of secondary closure of right mandibular impacted third molars. Basement evaluations were recorded for each patient along with subjective and objective evaluations for postoperative 7 days. Data analysis was carried out by SPSS 17.0 software using Mann-Whitney U test, Wilcoxon matched-pairs test and t-test. A p-value ≤ 0.05 was assigned as statistically significant. Results: When compared to group 1, group 2 revealed statistically less pain and swelling following the secondary closure of wound from day 1 to 7. There was a significant improvement in mouth opening in Group 2 at day 1 (p=0.0005) and at day 7 (p=0.00001). Conclusion: Secondary wound closure after disimpaction of mandibular third molar results in better postoperative recovery than primary closure.

Evaluation of the Effect of Primary and Secondary Closure on the Use of Leukocyte and Platelet Rich Fibrin in Impacted Lower Third Molar Surgery

“…They showed that the groups treated with L-PRF had better wound healing scores than the control group at 1, 2 and 3 weeks [28]. When comparing the effects of primary and secondary closure methods in routine lower impacted wisdom tooth surgery without L-PRF, it is generally reported in the literature that the secondary closure method has fewer postoperative complications, especially pain and swelling [12,[14][15][16]. In contrast to our study, studies using L-PRF have compared primary and secondary closure methods with the control group.…”

“…However, wound closure after surgery is an ongoing debate. When the studies evaluating the closure method of the lower impacted wisdom tooth surgery without L-PRF are examined, it is seen that the primary closure method is recommended in the old studies, while the secondary closure method is recommended in the current studies in terms of complications [12][13][14][15][16]. There are no studies reporting which closure technique is more successful in preventing or reducing postoperative complications after impacted lower third molar surgery when L-PRF is used.…”