Assessment of the effect of wound closure technique on postoperative sequaele and complications after impacted mandibular third molar extraction

摘要

Aims and Objectives: The aim of the study was to compare the effect of complete and partial wound closures on postoperative sequelae and complications after surgical removal of impacted mandibular third molars. Patients and Methods: One hundred and twenty patients who required 121 surgical extractions of mandibular impacted third molars were included in the study. Patients were randomly divided into 2 groups based on wound closure after surgery. In group 1 (complete wound closure, n1 = 60) patients had their extraction sockets completely closed by mucosal flap while in group 2 (partial wound closure, n2 = 60) patients had their extraction sockets partially closed. Data collected included maximum inter-incisal distance (MID) and facial width which were recorded both preoperatively and postoperatively. What also recorded were postoperative pain intensity and postoperative complications. Results: There were 50 (41.7%) males and 70 (58.3%) females (male to female ratio of 1:1.4);age range was 18-40 years and the mean was 26 ± 10 years. The mean ages of patients in both groups showed no significant difference (group 1 = 26.5 ± 7.2;group 2 = 27.1 ± 8.1). The pain was maximal at the first postoperative day review and it gradually reduced in intensity towards the preoperative values for both groups. The pain perceptionsin patients in group 2 were however significantly lower than those of group 1 on days 1 and 3 but not statistically different on day 7. The mean difference in the postoperative and preoperative MID was greatest on the 1st postoperative day and gradually became smaller on the subsequent review days. Comparison of this mean difference between the 2 groups however showed a significant difference in the 2 groups only on day 7. Maximal swelling was noted in both groups on the third postoperative day. A comparison of the mean facial width between the two groups showed no statistically significant difference on all the review days. The postoperative complication rate was 5% in both groups. Conclusions: The results of the study indicate that there was a comparative reduction in postoperative sequelae namely pain and trismus after impacted mandibular third molar surgery when a partial wound closure technique was done. However, there was no significant difference in the postoperative complication rate between the two groups.