Comparison Between Primary Closure and Healing by Second Intention After Third Molar Extraction

Abstract

Objectives: To determine the effectiveness of secondary intention healing compared to primary closure in minimizing pain, edema, and trismus after third molar extraction. Literature Review: This Integrative Literature Review analyzed two controlled clinical trials. The sutureless technique creates a “pseudo-socket,” allowing continuous drainage of inflammatory exudate, thereby reducing internal pressure and discomfort. The results indicate that this approach reduces surgical time by na average of 3.6 minutes and presents a lower infection rate (5.8% versus 17% with primary closure). While one study demonstrated a significant reduction in pain, edema, and trismus with the secondary technique, the other found no statistical difference in these sequelae, although it confirmed the method’s speed and safety. In addition, smoking increases complications by 3.65 times. Final Considerations: Secondary intention healing is a safe and promising alternative, capable of optimizing clinical time and improving patient recovery. However, due to the scarcity of rigorous studies, the current level of evidence remains low. Further randomized split-mouth clinical trials are needed to consolidate these findings in dental practice.