A Comparative Study of the Effect of Primary and Secondary Closure Technique Following Removal of Impacted Mandibular Third Molars

Introduction: Surgical removal of the impacted mandibularthird molar is one of the most frequently performed surgicalprocedures in oral and maxillofacial surgery. The purpose ofthis study was to compare the primary and secondary woundclosure after surgical removal of impacted mandibular thirdmolars by evaluating the extent of facial swelling, the severityof pain and degree of trismus.Material and Methods: A prospective, randomized,clinical trial was conducted in 80 patients. The patients wererandomly divided into two groups of 40 each. In Group 1:patients underwent primary closure of the wound and inGroup 2: patients underwent secondary closure of the wound.Postoperative pain, swelling, and trismus were evaluated onthe 2nd and 7th day postoperatively.Results: Statistically significant difference was observed forfacial swelling and trismus on 2nd postoperative days betweenboth groups. Postoperative pain was less in the secondaryclosure group.Conclusion: From the outcome of the above study we canconclude that the secondary wound closure technique has asignificant advantage over primary wound closure concerningswelling and trismus.

Temporomandibular Joint Manifestations in Rheumatoid Arthritis: A Case Report.

Rheumatoid arthritis (RA) is a chronic infl ammatory disease characterized by joint swelling, joint tenderness, and ravagement of synovial joints, leading to rigorous incapacitation, and premature mortality. It was fi rst described by Dr. Augustin Jacob Landr´e-Beauvais in 1800. RA aff ects about 1% population worldwide. Temporomandibular joint (TMJ) involvement is usually found along with the involvement of the joints of the hands and feet. TMJ involvement is associated with pain, infl ammation, limited joint movements, swelling, joint stiff ness, and muscle spasm. Radiological features include cortical erosion, decreased joint space, de-ossifi cation, sharpen pencil head or spiked deformity or mouthpiece of fl ute deformity of the condylar head. Clinical examination and investigations (radiographic and hematological) remain the mainstay of diagnosis. Here, we present a case of RA of TMJ along the joints of the hands and feet.