A Comparative Study of Primary Versus Secondary Closure After Removal of Lower Third Molar

Introduction: The purpose of this study was to clinically compare the post-operative sequelae of wound healing and patient response after primary and secondary closure. The effectiveness of the technique was evaluated relative to the degree of patient comfort and the post-operative condition of the surgical site.Method: This prospective study was conducted on 50 patients. The patients were selected randomly from the outpatient department needing surgical removal of impacted mandibular third molars. The patients were then randomly allocated to any of the two groups- the primary closure and the secondary closure group. In the primary closure group, after removal of third molar flap was hermetically sutured and in secondary closure group, a wedge of mucosa of 5-6 mm was removed distal to second molar for secondary healing. Maximum mouth opening and facial swelling were measured at preoperatively, 6 hours and at days 2, 4and 7 postoperatively. Pain was objectively measured using a visual analogue scale at above time points. The data collected was subjected to students unpaired't'- test.Results: The secondary closure of the wound proved more successful in preventing post-surgical sequelae of impacted third molar removal. Post-operative analysis showed increased amount of swelling, pain and trismus in primary closure group as compare to secondary closure group and the difference was statistically significant.Conclusion: The results of this study suggest that the secondary healing after impacted lower third molar removal may have considerable contributions to reduce the post-operative swelling, pain and trismus.