Comparison of primary and secondary closure techniques after removal of impacted mandibular third molars

There is a diversity of opinion among authors of oral surgery textbooks regarding the technique of wound closure after removal of impacted mandibular third molars. A primary closure is preferred by Howe,¹ Archer,² Guralnick,³ Kruger,⁴ Thoma,⁵ and Killey and Kay.⁶ Other authors, however, prefer the wounds to heal by secondary intention. They include Bourgoyne,⁷ Blair and Ivy,⁸ Padgett,⁹ and Mead.¹⁰ The use of a drain is also suggested.^8,9 On the other hand, Clark¹¹ and Winter¹² indicate that the wounds may be treated by either method, and Woodward¹³ advocates the use of a small V-opening posterior to the second molar to facilitate postoperative irrigation of the wound. We were unable to find reports of an objective evaluation of the various closure techniques.The purpose of this study was to compare closure by primary intention and a closure that used a window, with healing by secondary intention. The effectiveness of the techniques was evaluated relative to the degree of patient comfort and the postoperative condition of the surgical site.