Comparing Pain and Trismus in “Primary” and “Secondary” closure of surgical wound after removal of Impacted Mandibular Third Molar

  • Eruj Shuja
  • Gulmina Saeed Orakzai
  • Muhammad Nazir Khan
  • Mohammed Omer Siddiqui
Keywords: Flap closure, impacted third molar, pain, primary closure, secondary closure, trismus.


Background: Surgical removal of third molars is a routine procedure in Oral and Maxillofacial units. Different techniques are adopted by oral and maxillofacial surgeons for surgical wound closure such as primary and secondary closure. The objective of this study is to compare post-operative surgical complications such as pain and trismus in primary and secondary closure techniques after the surgical removal of the impacted mandibular third molar.
Methods: This randomized control trial was conducted in the Oral and Maxillofacial Department, Armed Forces Institute of Dentistry Rawalpindi. A total of 60 patients, 30 in each treatment group were included, Group 1 went under primary closure and Group 2 secondary closure. Pain assessment was done using visual analogue scale VAS and trismus calculated measuring inter incisal opening on the 7th post-operative day. Data was analysed using SPSS- 18. Descriptive statistics were employed for quantitative variables. Mean and standard deviation calculated. An independent sample t-test was used to compare mean pain and trismus between two groups. P-value ≤0.05 was considered significant.
Results: Out of 60 patients 37(61.7%) were males and 23(38.3%) females. The age range was 18 to 45 years. The most common age range in the study was 21 to 25 years (35%). Six (10%) patients presented with a dry socket. Eight patients (13.3%) presented with wound dehiscence, in primary closure. The Pain was more severe in primary closure as compared to secondary closure. The difference was statistically significant (p-value=0.002). Trismus was also more common in primary closure, the difference was statistically significant (p-value=0.003).
Conclusion: Pain and trismus was less severe in secondary closure as compared to primary closure

How to Cite
Shuja E, Orakzai G, Khan M, Siddiqui M. Comparing Pain and Trismus in “Primary” and “Secondary” closure of surgical wound after removal of Impacted Mandibular Third Molar. JRMC [Internet]. 28Mar.2020 [cited 4Oct.2022];24(1):8-1. Available from: