How effective is collagen resorbable membrane placement after partially impacted mandibular third molar surgery on postoperative morbidity? A prospective randomized comparative study

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.

Comparative Efficacy of Two Hemostatic Agents in Post-Extraction Bleeding Control Following Mandibular Third Molar Surgery: A Randomized Clinical Trial

“…Similarly, Kim et al [13] found that collagen-based hemostatic sponges were effective in reducing pain and promoting healing, supporting our findings of equivalent outcomes for both agents. However, while Kilinc and Ataol [43] reported enhanced healing outcomes with the use of membranes in surgical wounds, our study did not observe such differences for these hemostatic sponges. This discrepancy may be attributed to differences in study design, follow-up duration, or the specific surgical contexts evaluated.…”

Comparative Efficacy of Two Hemostatic Agents in Post-Extraction Bleeding Control Following Mandibular Third Molar Surgery: A Randomized Clinical Trial

“…Similarly, Kim et al [13] found that collagen-based hemostatic sponges were effective in reducing pain and promoting healing, supporting our findings of equivalent outcomes for both agents. However, while Kilinc and Ataol [43] reported enhanced healing outcomes with the use of membranes in surgical wounds, our study did not observe such differences for these hemostatic sponges. This discrepancy may be attributed to differences in study design, follow-up duration, or the specific surgical contexts evaluated.…”

The effect of autologous demineralized dentin matrix on postoperative complications and wound healing following lower third molar surgery: A split-mouth randomized clinical trial

“… 16 Interestingly, other trials with collagen membranes or autologous bone depicted a significant increase in trismus in the experimental groups. 24 , 25 Paricularly, the slight increase in pain, swelling, and trismus on the DDM side compared with the control side in this study may be because of an inflammatory reaction against the dentin material in the L3M socket. Moreover, we proposed a different mechanism in which the placement of the grafting material occupied some space inside the tooth socket and may further increase compression of the surrounding structure.…”

“…However, the difference from the control group was not significant. 24 Sánchez-Labrador et al. also reported an insignificant increase in trismus following L3M extraction with dentin grafts compared to L3M extraction only.…”

“… 16 Studies utilizing other grafting materials like autologous bone and collagen membrane to preserve the tooth socket also showed comparable results regarding pain. 24 , 25 Prior studies utilizing dentin materials for grafting have not evaluated swelling consequences. A previous study in which collagen membranes were placed in tooth sockets also revealed a higher swelling level on the grafting side.…”

Aetiology, Prevention and Management of Alveolar Osteitis—A Scoping Review

“…One comparative study and one cohort study assessed the use of a resorbable collagen membrane to prevent AO 39,57 . While the results of the studies were not statistically significant, both noted a reduction in AO incidence with these membranes.…”

Comparative Efficacy of Two Hemostatic Agents in Post-Extraction Bleeding Control Following Mandibular Third Molar Surgery: A Randomized Clinical Trial

“…Similarly, Kim et al [13] found that collagen-based hemostatic sponges were effective in reducing pain and promoting healing, supporting our findings of equivalent outcomes for both agents. However, while Kilinc and Ataol [43] reported enhanced healing outcomes with the use of membranes in surgical wounds, our study did not observe such differences for these hemostatic sponges. This discrepancy may be attributed to differences in study design, follow-up duration, or the specific surgical contexts evaluated.…”

The effect of autologous demineralized dentin matrix on postoperative complications and wound healing following lower third molar surgery: A split-mouth randomized clinical trial

“… 16 Interestingly, other trials with collagen membranes or autologous bone depicted a significant increase in trismus in the experimental groups. 24 , 25 Paricularly, the slight increase in pain, swelling, and trismus on the DDM side compared with the control side in this study may be because of an inflammatory reaction against the dentin material in the L3M socket. Moreover, we proposed a different mechanism in which the placement of the grafting material occupied some space inside the tooth socket and may further increase compression of the surrounding structure.…”

“…However, the difference from the control group was not significant. 24 Sánchez-Labrador et al. also reported an insignificant increase in trismus following L3M extraction with dentin grafts compared to L3M extraction only.…”

“… 16 Studies utilizing other grafting materials like autologous bone and collagen membrane to preserve the tooth socket also showed comparable results regarding pain. 24 , 25 Prior studies utilizing dentin materials for grafting have not evaluated swelling consequences. A previous study in which collagen membranes were placed in tooth sockets also revealed a higher swelling level on the grafting side.…”

Aetiology, Prevention and Management of Alveolar Osteitis—A Scoping Review

“…One comparative study and one cohort study assessed the use of a resorbable collagen membrane to prevent AO 39,57 . While the results of the studies were not statistically significant, both noted a reduction in AO incidence with these membranes.…”

Comparative Efficacy of Two Hemostatic Agents in Post-Extraction Bleeding Control Following Mandibular Third Molar Surgery: A Randomized Clinical Trial

“…Similarly, Kim et al [13] found that collagen-based hemostatic sponges were effective in reducing pain and promoting healing, supporting our findings of equivalent outcomes for both agents. However, while Kilinc and Ataol [43] reported enhanced healing outcomes with the use of membranes in surgical wounds, our study did not observe such differences for these hemostatic sponges. This discrepancy may be attributed to differences in study design, follow-up duration, or the specific surgical contexts evaluated.…”

The effect of autologous demineralized dentin matrix on postoperative complications and wound healing following lower third molar surgery: A split-mouth randomized clinical trial

“… 16 Interestingly, other trials with collagen membranes or autologous bone depicted a significant increase in trismus in the experimental groups. 24 , 25 Paricularly, the slight increase in pain, swelling, and trismus on the DDM side compared with the control side in this study may be because of an inflammatory reaction against the dentin material in the L3M socket. Moreover, we proposed a different mechanism in which the placement of the grafting material occupied some space inside the tooth socket and may further increase compression of the surrounding structure.…”

“…However, the difference from the control group was not significant. 24 Sánchez-Labrador et al. also reported an insignificant increase in trismus following L3M extraction with dentin grafts compared to L3M extraction only.…”

“… 16 Studies utilizing other grafting materials like autologous bone and collagen membrane to preserve the tooth socket also showed comparable results regarding pain. 24 , 25 Prior studies utilizing dentin materials for grafting have not evaluated swelling consequences. A previous study in which collagen membranes were placed in tooth sockets also revealed a higher swelling level on the grafting side.…”

Aetiology, Prevention and Management of Alveolar Osteitis—A Scoping Review

“…One comparative study and one cohort study assessed the use of a resorbable collagen membrane to prevent AO 39,57 . While the results of the studies were not statistically significant, both noted a reduction in AO incidence with these membranes.…”