Comparative evaluation of primary and secondary closure after surgical removal of impacted mandibular third molar

This study was conducted to compare the efficacy of primary and secondary closure techniques after surgical removal of impacted mandibular third molar. A total of 200 patients (aged 17–30 years) were divided into two matched groups – Group I (n = 100), managed by repositioning of flap to obtain primary closure, Group II (n = 100), by removal of 6–7 mm wedge of mucosa adjacent to the second molar to obtain secondary closure. Comparison was done at postoperative days 1, 3, 7, 15 and 30 using Student “t”-test. Preoperatively, no significant difference was observed between two groups for pain score, swelling, and mouth opening. Mean pain score and mean swelling were significantly lower in Group II as compared to Group I while mean mouth opening was significantly higher in Group II as compared to Group I on postoperative day one. Comparable pain, swelling and mouth opening in both the groups were achieved on postoperative day 7 onwards. The results in present study favor the secondary closure of socket as it causes lesser postoperative swelling and pain as well as early improvement in mouth opening.