[The surgical removal of the lower wisdom teeth. Is open follow-up care still up-to-date?].

The removal of lower wisdom teeth is one of the most common procedures in oral surgery. Postoperative complications have been reported in over 10% of the cases, of those being 8.5% due to infection. In our Department, the open wound healing method has been used routinely for more than 50 years. In this article we present a retrospective and a prospective study comparing the open and closed wound healing techniques after lower third molar removal. The retrospective study dealt with 908 consecutive cases of the year 1991 in which all postoperative complications were analysed. The prospective controlled randomized study dealt with 300 cases in which the open and the half closed wound treatment was compared. Preoperative data including the papillary bleeding index and the postoperative incidence of infections were analysed. In the open wound healing group, a complication rate of 3%, with less than 1% being infectious, was observed. In the group where a semi-closed procedure was performed, a complication rate of more than 13% with 6% infections was found. It could be demonstrated that poor oral hygiene influences the postoperative infection rate, especially in cases where the semi-closed wound healing was used, whereas open wound healing is less affected by the status of oral hygiene. In both methods approximately three postoperative consultations were necessary. Based on these results, the open wound healing method after surgical removal of lower wisdom teeth is advocated.