Postoperative Pain Perception and Patient’s Satisfaction After Mandibular Third Molar Surgery by Primary Closure With Distal Wedge Surgery

Abstract

Background The aim of this study was to compare periodontal conditions of the distal aspect of mandibular second molar and patient’s satisfaction between standard surgical technique and primary closure with or without distal wedge surgery used for the removal of mandibular third molar impaction (MTMI). Methods Twenty-four patients, aged 18 - 25 years, were invited to participate in this prospective, single-blinded, split-mouth randomized controlled study. Each participant owned similar bilateral impacted mandibular third molar. Periodontal parameters (i.e. probing depth (PD), gingival index (GI), plaque index (PI) and the distance from cusp tip to gingival margin (CT-GM)) were measured. The standard mandibular third molar surgery was performed on one side while for the other side the distal wedge surgery with or without osseous contouring was added to the protocol. Information about satisfaction was taken from questionnaire. Results At the site where distal wedge was performed, significant change in CT-GM occurred at all aspects and a significant PD reduction was observed at disto-buccal and mid-distal sites. Distance between cemento-enamel junction (CEJ) and gingival margin reduced significantly at all sites. No significant difference between two groups was found in GI, PI and patient’s satisfaction. Conclusions Incorporating distal wedge surgery into MTMI removal protocol does improve periodontal health of adjacent second molar and does not affect patient’s satisfaction.

Surgical extraction of the impacted mandibular third molar: Vestibular bone window technique

“…[5] However, there are no clear scientific data to explain the outcome of third molar surgical extraction on M2M periodontal status [6][7][8]. It is also unclear how the flap design [9][10][11] or suturing technique [12] will alter the results.…”

Surgical Management of Impacted Lower Second Molars: A Comprehensive Review

“…Additionally, it facilitates healthy healing around the second lower molar tissues. This method was applied by Leechanavanichpan et al 39 in 2019, where impacted mandibular third molar was surgically removed with distal wedge incision, and it created positive periodontal clinical outcomes. The distal wedge technique is mostly used during odontectomy procedures and can be beneficial in second mandibular molar uprighting, preventing clinical attachment loss and plaque retention to the distal part of the molar.…”