Title: Effect of collagen plug application on healing of the extraction socket after surgical removal of a partially impacted mandibular third molar: A randomized split-mouth clinical trial
Abstract:
Objectives: Surgical extraction of partially impacted mandibular third molars is one of the most common procedures in oral surgery. Due to limited soft tissue coverage, primary closure is often incomplete, which can result in prolonged postoperative complications such as edema, delayed healing, and food impaction. This study aimed to evaluate the effectiveness of a bovine-derived collagen plug in enhancing soft tissue healing and socket preservation following surgical extraction.
Materials and Methods: This randomized split-mouth clinical trial included 30 patients requiring bilateral surgical extraction of partially impacted lower third molars. Each patient underwent two surgeries with a 4-week interval; one side received a bovine collagen plug (Bone Protect Cone, Dentegris, Germany) into the extraction socket, while the contralateral side served as the control. Postoperative parameters—edema (linear measurements), pain (Visual Analog Scale), socket dimensions (caliper), and maximal interincisal mouth opening—were assessed on days 2, 7, and 14. Data were analyzed using SPSS v22 with a significance threshold of p<0.05.
Results: Collagen plug application significantly reduced edema on days 2 and 7 (p<0.001), but not at day 14 (p>0.05). The socket dimension was significantly smaller in the collagen group at all time points (p<0.001). There was no statistically significant difference in postoperative pain scores or mouth opening between groups (p>0.05).
Conclusion: Collagen plugs improve early soft tissue healing and reduce socket dimensions following third molar surgery. This low-cost, biocompatible intervention can be recommended as a supportive approach to enhance healing in cases of partial impaction where primary closure is difficult.
