A Prospective Randomized Clinical Study of the Influence of Primary Closure or Dressing on Post‑operative Morbidity after Mandibular Third Molar Surgery

Abstract

Objective: The aim of the following study is to determine the effect of primary closure or dressing on post‑operative morbidity after impacted lower third molar surgery. Materials and Methods: This was a randomized clinical study of 72 patients who had surgical extraction of impacted mandibular third molars. The subjects were divided into two groups of A and B. Group A had total closure (primary closure) and Group B had whitehead varnish dressing of the socket. Pain, swelling and trismus were evaluated pre‑operatively using visual analogue scale, flexible tape measuring method and inter‑incisal distance measurement with Vernier Callipers respectively as well as post‑operatively on 1^st, 2^nd, 3^rd, 5^th and 7^th day. Results: The study participants consisted of 27 males and 45 females in a ratio 1:1.7. With a mean age of 24.7 ± 4.9 years (range 19‑33 years) for Group A and 25.5 ± 4.3 years (range 20‑39 years) for Group B. Post‑operative pain was not significantly affected by the closure techniques (P > 0.05). Dressing was found to significantly reduce the degree of swelling and trismus peaking on the 2^nd day (P = 0.0207 and P = 0.010 respectively). Conclusion: The use of dressing was more effective than primary closure to reduce the degree of swelling and trismus though its effect on post‑operative pain reduction was not significant.

Keywords: Dressing, primary closure, randomized, surgery, third molars