Postoperative Pain Perception and Patients Satisfaction After Mandibular Third Molar Surgery by Primary Closure With Distal Wedge Surgery

Poompat Leechanavanichpan, Pirasut Rodanant, Rachatawan Leelarungsun, Natthamet Wongsirichat


Background: The aim of this study was to compare periodontal conditions of the distal aspect of mandibular second molar and patients satisfaction between standard surgical technique and primary closure with or without distal wedge surgery used for the removal of mandibular third molar impaction (MTMI).

Methods: Twenty-four patients, aged 18 - 25 years, were invited to participate in this prospective, single-blinded, split-mouth randomized controlled study. Each participant owned similar bilateral impacted mandibular third molar. Periodontal parameters (i.e. probing depth (PD), gingival index (GI), plaque index (PI) and the distance from cusp tip to gingival margin (CT-GM)) were measured. The standard mandibular third molar surgery was performed on one side while for the other side the distal wedge surgery with or without osseous contouring was added to the protocol. Information about satisfaction was taken from questionnaire.

Results: At the site where distal wedge was performed, significant change in CT-GM occurred at all aspects and a significant PD reduction was observed at disto-buccal and mid-distal sites. Distance between cemento-enamel junction (CEJ) and gingival margin reduced significantly at all sites. No significant difference between two groups was found in GI, PI and patients satisfaction.

Conclusions: Incorporating distal wedge surgery into MTMI removal protocol does improve periodontal health of adjacent second molar and does not affect patients satisfaction.

J Clin Med Res. 2019;11(7):489-494


Distal wedge surgery; Mandibular third molar impaction; Patientís satisfaction; Periodontal health

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