Effect of Intraoral Drainage after Impacted Mandibular Third Molar Extraction on Non-Infectious Postoperative Complications

Abstract

Surgical removal of mandibular third molars is associated with non-infectious postoperative complications, including pain, swelling, trismus. Intraoral drains are noteworthy because of their ease of application, availability, and effectiveness. This study aimed to evaluate the use of latex and calcium–sodium alginate mouth flat drains on the severity of postoperative complications such as pain, trismus, and edema after surgical removal of mandibular third molars. Ninety patients who underwent surgical removal of wisdom teeth were studied. The patients were divided into three groups. Group A—with a latex flat drain, group B—with a sodium–calcium alginate (Kaltostat) flat drain, and group C—with a wound closed with knotted sutures. Patients were assessed for pain on a VAS scale every day from surgery to postoperative day 7. Before the procedure and on postoperative days 1, 2, and 7, the pain level, edema, and trismus were measured, respectively. Intraoral drainage with a flat drain after mandibular third molar removal does not significantly reduce pain, as measured by the VAS scale, or postoperative swelling, as measured by lines between craniometric points. Intraoral drainage with a latex drain after mandibular third molar removal does not significantly reduce trismus, while intraoral drainage with a calcium–sodium alginate drainage bag significantly increases trismus.

Comparative Evaluation of the Placement of Drain Versus Normal Suturing to Eliminate Postoperative Complications After the Surgical Removal of Impacted Third Molar

“…Due to the flat drain's near-invisibility in the mouth and ease of removal, patients do not experience as much discomfort. After surgery, knotted sutures are used to secure the extraction site, which lessens postoperative bleeding and helps avoid post-extraction alveolitis by trapping the clot within the alveolus [ 1 ]. Since sutures were used in both groups, neither group experienced a dry socket by the end of day 7.…”

“…Surgical extraction of impacted third molars is one of the most common surgical treatments provided by oral surgeons in dental clinics. Erupting third molars is the most common cause of pain, and it may be complicated by periapical inflammation, abscess, phlegm, or cyst [ 1 ]. Typical side effects experienced following extraction of an impacted tooth are reportedly pain, trismus, edema, and dry socket.…”

“…When the draining fluid is too viscous to move via tubes, these drains are utilized. There is less tissue damage, reduced wound infection, and no skin excoriation [ 1 ].…”

Complications post simple exodontia: A systematic review

“…78 In addition, the placement of an intraoral latex drainage system after exodontia of impacted mandibular third molars has been associated with a faster and less traumatic recovery. 79 Although, the mentioned studies were carried out in relation to exodontia of impacted third molars, it is prudent to consider these therapies in the case of extractions that are complicated and associated with prolonged surgical times.…”

Microbiological Retention on PTFE versus Silk Suture: A Quantitative Pilot Study in Third Molar Surgery

“…With regards to suture technique in M3M surgery, international literature provides sutureless techniques, single suture techniques, different knotless suture techniques and the use of sutureless release incision techniques: each of these reported small advantages in terms of postoperative symptoms, time spent for suture and time saved after surgery [ 5 , 6 , 7 , 8 , 9 ]. Drainage inside the wound after M3M extraction and its retention until suture removal may have a role to reduce postoperative complications, too [ 10 ]. Among the complications that may appear after M3M surgery, alveolar osteitis and infection represent the most common and most feared adverse events [ 3 ].…”