Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Investigation of the Relationship Between Primary and Secondary Wound Healing After Surgical Extraction of Maxillary Third Molar Teeth with Different Impaction Degrees and Postoperative Complications
Farklı Gömülülük Derecelerine Sahip Maksiller Üçüncü Molar Dişlerin Cerrahi Ekstraksiyonu Sonrası Primer ve Sekonder Yara İyileşmesi ile Postoperatif Komplikasyonlar Arasındaki İlişkinin Araştırılması
Poyzan BOZKURTa
aAnkara University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ankara, TURKEY
Turkiye Klinikleri J Dental Sci. 2020;26(2):166-72
doi: 10.5336/dentalsci.2019-66828
Article Language: EN
Full Text
ABSTRACT
 Objective: The purpose of this prospective, randomized, split-mouth clinical trial was to evaluate the effects of sutureless healing after surgical removal of impacted maxillary third molars. Material and Methods: Sixty patients, aged between 18-40, with symmetrical positioned bilateral impacted maxillary third molars, were included. According to Pell and Gregory's classification of depths, patients were divided into 3 groups, each containing 20 patients. After surgeries, one side was primarily sutured; the other side was left unsutured for secondary healing. Operation times and postoperative complications including pain, oedema, alveolar osteitis, infection and excessive bleeding were examined for each side. Results: Operative time was higher in all sutured wounds. Pain was higher in Class-B sutured wounds during the 6th, 12th hours compared to Class-B unsutured wounds; however, no significant difference was observed between sutured and unsutured wounds in Class-A and Class-C. Postoperative oedema, alveolar osteitis, bleeding and infection values presented no significant difference between sutured and unsutured wounds in all impaction groups. All wounds healed at 1- week follow-ups. Conclusion: We are of the opinion that regardless of impaction degree; unsutured secondary healing for intraoral wounds may be a safe technique for upper impacted third molar surgery. Due to the fact that operative time is shortened, it might increase patient satisfaction.

Keywords: Impacted tooth; third molar; maxilla; wound healing; postoperative complications
ÖZET
 Amaç: Bu prospektif, randomize, bölünmüş-ağız klinik çalışmanın amacı, maksiller gömülü üçüncü molar diş cerrahisi sonrası sütürsüz iyileşmenin etkilerini değerlendirmekti. Gereç ve Yöntemler: 18-40 yaş arası, çift taraflı simetrik pozisyonlu maksiller gömülü üçüncü molar dişlere sahip 60 hasta çalışmaya dahil edildi. Pell ve Gregory'nin gömülülük sınıflamasına göre, hastalar 20 kişilik 3 gruba ayrıldı. Ameliyatlardan sonra rastgele bir taraf birincil iyileşme sağlamak amacıyla dikildi; diğer taraf ikincil iyileşme sağlamak amacıyla dikişsiz olarak bırakıldı. İki ameliyat sahası için ayrı olacak şekilde, ameliyat süreleri ve ağrı, ödem, alveoler osteit, enfeksiyon ve aşırı kanama gibi ameliyat sonrası komplikasyonlar değerlendirildi. Bulgular: Tüm sütürlü yaralarda ameliyat süresi daha fazlaydı. Altıncı ve 12. Saatlerde Pell ve Gregory B Sınıfı süturlu yaralarda ağrı, sütursuz yaralara göre daha yüksekti; bununla birlikte, Pell ve Gregory A-Sınıfı ve C-Sınıfında süturlu ve sütursuz yaralar arasında anlamlı bir fark gözlenmedi. Postoperatif ödem, alveolit, kanama ve enfeksiyon değerleri, tüm gömülülük gruplarında sütürlü ve sütürsüz yaralar arasında anlamlı bir farklılık göstermedi. Tüm yaralar 1 haftalık takiplerde iyileşme gösterdi. Sonuç: Gömülülük derecesi ne olursa olsun; maksiller gömülü üçüncü molar dişler için sekonder iyileşme, güvenli bir teknik olabilir. Ameliyat süresinin kısalması nedeniyle hasta memnuniyetini artırabilir.

Anahtar Kelimeler: Gömülü diş; üçüncü azı dişi; maksilla; yara iyileşmesi; postoperatif komplikasyonlar
REFERENCES:
  1. Hupp JR, Ellis E, Tucker MR. Contemporary Oral and Maxillofacial Surgery. 6th ed. New Delhi, India: Elsevier Health Sciences; 2014. p.143-6.
  2. Sanchis Bielsa JM, Hernández-Bazán S, Pe-arrocha Diago MP. Flap repositioning versus conventional suturing in third molar surgery. Med Oral Patol Oral Cir Bucal. 2008;13(2):E138-42.
  3. Bouloux GF, Steed MB, Perciaccante VJ. Complications of third molar surgery. Oral Maxillofac Surg Clin North Am. 2007;19(1):117-28. [Crossref]  [PubMed] 
  4. Osunde OD, Adebola RA, Saheeb BD. A comparative study of the effect of suture-less and multiple suture techniques on inflammatory complications following third molar surgery. Int J Oral Maxillofac Surg. 2012;41(10):1275-9. [Crossref]  [PubMed] 
  5. Pasqualini D, Cocero N, Cateslla A, Mela L, Bracco P. Primary and secondary closure of the surgical wound after removal of impacted mandibular third molars: a comparative study. Int J Oral Maxillofac Surg. 2005;34(1):52-7. [Crossref]  [PubMed] 
  6. Chaudhary M, Singh M, Singh S, Singh SP, Kaur G. Primary and secondary closure technique following removal of impacted mandibular third molars: a comparative study. Natl J Maxillofac Surg. 2012;3(1):10-4. [Crossref]  [PubMed]  [PMC] 
  7. Osunde OD, Saheeb BD, Adebola RA. Comparative study of effect of single and multiple suture techniques on inflammatory complications after third molar surgery. J Oral Maxillofac Surg. 2011;69(4):971-6. [Crossref]  [PubMed] 
  8. Danda AK, Krishna Tatiparthi M, Narayanan V, Siddareddi A. Influence of primary and secondary closure of surgical wound after impacted mandibular third molar removal on postoperative pain and swelling--a comparative and split mouth study. J Oral Maxillofac Surg. 2010;68(2):309-12. [Crossref]  [PubMed] 
  9. Carrasco-Labra A, Brignardello-Petersen R, Yanine N, Araya I, Gyatt G. Secondary versus primary closure techniques for the prevention of postoperative complications following removal of impacted mandibular third molars: a systematic review and meta-analysis of randomized controlled trials. J Oral Maxillofac Surg. 2012;70(8):e441-57. [Crossref]  [PubMed] 
  10. Waite PD, Cherala S. Surgical outcomes for suture-less surgery in 366 impacted third molar patients. J Oral Maxillofac Surg. 2006;64(4):669-73. [Crossref]  [PubMed] 
  11. Cerqueira PR, Vasconcelos BC, Bessa-Nogueira RV. Comparative study of the effect of a tube drain in impacted lower third molar surgery. J Oral Maxillofac Surg. 2004;62(1):57-61. [Crossref] 
  12. Chukwuneke FN, Oji C, Saheeb DB. A comparative study of the effect of using a rubber drain on postoperative discomfort following lower third molar surgery. Int J Oral Maxillofac Surg. 2008;37(4):341-4. [Crossref]  [PubMed] 
  13. Rakprasitkul S, Pairuchvej V. Mandibular third molar surgery with primary closure and tube drain. Int J Oral Maxillofac Surg. 1997;26(3):187-90. [Crossref] 
  14. Kareem JJ. A comparison between primary and secondary wound closure after surgical removal of lower third molars according to pain and swelling. Mustansiria Dental Journal. 2008;5(4):410-7.
  15. Maria A, Malik M, Virang P. Comparison of primary and secondary closure of the surgical wound after removal of impacted mandibular third molars. J Maxillofac Oral Surg. 2011;11(3):276-83. [Crossref]  [PubMed]  [PMC] 
  16. Hashemi HM, Beshkar M, Aghajani R. The effect of sutureless wound closure on postoperative pain and swelling after impacted mandibular third molar surgery. Br J Oral Maxillofac Surg. 2012;50(3):256-8. [Crossref]  [PubMed] 
  17. Ordulu M, Aktas I, Yalcin S, Azak A, Evli̇oğlu G, Disçi̇ R, et al. Comparative study of the effect of tube drainage versus methylprednisolone after third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(6):e96-e100. [Crossref]  [PubMed] 
  18. Politis C, Schoenaers J, Jacobs R, Agbaje JO. Wound healing problems in the mouth. Front Physiol 2016;7:507. [Crossref]  [PubMed]  [PMC] 

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