Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar;24(1):37-43.
doi: 10.1007/s10006-019-00814-w. Epub 2019 Nov 15.

Comparison of primary and secondary closure with a buccal mucosal-advancement flap on postoperative course after mandibular impacted third molar surgery

R Balamurugan  1 , Thomas Zachariah  2
Affiliations

Comparison of primary and secondary closure with a buccal mucosal-advancement flap on postoperative course after mandibular impacted third molar surgery

R Balamurugan et al. Oral Maxillofac Surg. 2020 Mar.

Abstract

Purpose: The purpose of this study was to compare primary and secondary wound closure with a buccal mucosal-advancement flap technique on the postoperative course after mandibular impacted third molar surgery.

Methods: The study was conducted on 150 patients who required surgical removal of impacted mandibular third molars under local anesthesia. The study subjects were divided into three groups of 50 patients each, based on the type of closure over the third molar socket. Patients in group I underwent primary closure of the socket with hermetic suturing of the flap, including the vertical release. In group II, a secondary closure was performed, leaving the socket communicating with the oral cavity. In group III, a buccal mucosal-advancement flap technique was employed to achieve primary closure of the flap over the socket while leaving the anterior vertical release, generously patent. All the patients were assessed for pain using the visual analogue scale (VAS), swelling, and mouth opening at postoperative intervals of 2, 4, and 7 days. The wound healing was assessed on day 7.

Results: Patients in the buccal mucosal-advancement flap group had significantly less pain and swelling and increased mouth opening compared with primary and secondary closure. Wound dehiscence was seen in 18 patients and alveolar osteitis in 4 patients in primary closure. Delayed wound healing with food accumulation was seen in 6 patients in secondary closure. No complications of flap dehiscence or breakdown were observed in the buccal mucosal-advancement flap group.

Conclusion: This study concludes that the buccal mucosal-advancement flap technique was a superior closure technique with less pain, swelling, trismus, and satisfactory wound healing compared with both primary and secondary closure after mandibular third molar surgery.

Keywords: Buccal mucosal-advancement flap; Impacted mandibular third molar surgery; Primary secondary closure.

PubMed Disclaimer

References

    1. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 May;107(5):630-40 - PubMed
    1. Br J Oral Maxillofac Surg. 1984 Feb;22(1):65-71 - PubMed
    1. J Maxillofac Oral Surg. 2011 Jun;10(2):112-7 - PubMed
    1. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Jan;93(1):7-12 - PubMed
    1. J Oral Maxillofac Surg. 2011 Jun;69(6):e24-30 - PubMed

LinkOut - more resources