Petronis Žygimantas, Zigmantavičius Jonas, Gervickas Albinas
Department of Maxillofacial, Faculty of Dentistry, Lithuanian University of Health Sciences, Eivenių g. 2, LT-50161 Kaunas Lithuania.
Stomatologija. 2020;22(4):107-115.
Evaluate the influence of different wound closure methods in terms of pain, swelling, trismus, infection and healing time after third molar extraction.
A literature analysis was performed according to PRISMA guidelines in search of clinical trials published between 2015 and 2020. Databases were searched using different combinations of the following keywords: mandibular impacted OR retained wisdom teeth OR third molar removal OR extraction AND surgical removal AND discomfort OR pain OR trismus OR swelling AND drain OR drainage. The literature search resulted in a total of 364 publications. Finally, 12 study articles were used in the present review, following a selection based on the preestablished eligibility criteria.
The significant difference between various wound closure ways and postoperative pain, swelling and trismus has been found in 8 of 12 analyzed articles. Three of five established beneficial effect of drain application. In other articles, examining different wound closure methodologies, significant benefits were found by using buccally based triangular, buccal mucosal-advancement, and modified envelope flap. Suture-less anterior releasing incision and secondary wound closure also could be favorable after removing impacted third molars.
There was no significant effect of a rubber drain on swelling, pain, trismus, or wound infections after removal of the asymptomatic impacted third molar(s). Secondary wound closure was found to ensure lower pain, swelling and trismus ratio with comparison to primary wound closure.
评估不同伤口闭合方法对第三磨牙拔除术后疼痛、肿胀、张口受限、感染及愈合时间的影响。
根据PRISMA指南进行文献分析，检索2015年至2020年发表的临床试验。使用以下关键词的不同组合在数据库中进行搜索：下颌阻生或存留智齿或第三磨牙拔除或拔牙与手术切除以及不适或疼痛或张口受限或肿胀与引流。文献检索共得到364篇出版物。最后，根据预先设定的纳入标准进行筛选，本综述使用了12篇研究文章。
在12篇分析文章中的8篇中发现了不同伤口闭合方式与术后疼痛、肿胀和张口受限之间的显著差异。在5篇已确定引流应用有益效果的文章中，有3篇。在其他研究不同伤口闭合方法的文章中，使用颊侧三角形、颊黏膜推进和改良信封瓣发现了显著益处。拔除阻生第三磨牙后，无缝合前松解切口和二期伤口闭合也可能是有利的。
拔除无症状阻生第三磨牙后，橡胶引流对肿胀、疼痛、张口受限或伤口感染无显著影响。与一期伤口闭合相比，二期伤口闭合可确保更低的疼痛、肿胀和张口受限发生率。
