Impacted tooth surgeries are among the most frequently performed procedures in oral and
maxillofacial surgery. These surgeries require intensive training, skill, and experience
to minimize trauma during the procedure. Despite careful and atraumatic surgical
techniques, complications such as pain, swelling, trismus, and bleeding often occur due
to surgical trauma. While these postoperative complications are addressed through
atraumatic approaches, their complete elimination remains unattainable. Consequently,
numerous studies have been conducted to minimize postoperative inflammatory
complications.
According to difficulty level parameters, surgical cases are categorized as
uncomplicated, moderately difficult, and difficult. Expected physiological responses to
surgical procedures, such as swelling, pain, mild bleeding, and muscle stiffness, may
arise depending on these difficulty levels. However, even these expected complications
can negatively impact the psychological well-being of patients and cause significant
postoperative discomfort.
To alleviate such discomfort and facilitate a smoother recovery, pharmacological
treatments, including non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids,
are commonly administered orally, intramuscularly, or submucosally before or after the
procedure. Additionally, extraoral cold applications (e.g., ice packs) are recommended to
reduce postoperative edema. However, the effectiveness of ice therapy remains
controversial, and no universally accepted non-pharmacological treatment has yet been
identified to mitigate expected postoperative inflammatory symptoms.
Negative Pressure Wound Therapy (NPWT) was first introduced in 1986. Its efficacy was
demonstrated in an animal study by Morykwas et al. and subsequently in a clinical trial
conducted by Argenta and Morykwas in 1997. These promising results led to the development
of a systematic device marketed under the name Vacuum Assisted Closure (VAC) by Kinetic
Concepts (KCI, San Antonio, TX, USA).
The beneficial effects of NPWT are thought to result from five primary mechanisms: macro
tension, micro tension, fluid and edema removal, reduction of infective material, and
wound stabilization. Given the inflammatory nature of complications following the
surgical extraction of impacted third molars, NPWT is hypothesized to be effective in
managing these issues. It is expected that NPWT may accelerate intraoral wound healing,
reduce postoperative edema and bacterial load, and consequently improve patients' quality
of life after surgery.
To date, there are no observational or interventional studies systematically examining
the intraoral application of NPWT. However, some literature suggests its extraoral use in
treating orocutaneous and pharyngocutaneous fistulas. Limited case reports have explored
intraoral applications, such as in drug-induced jaw necrosis and the decompression of
keratocystic lesions, showing promising outcomes.
This study aims to evaluate the effects of NPWT, a non-invasive and non-pharmacological
technique, on inflammatory symptoms-pain, swelling, and restricted mouth
opening-following the surgical extraction of impacted teeth. Furthermore, instead of
employing commercially available NPWT devices, this study seeks to develop and validate a
low-cost alternative using readily accessible materials. If successful, this approach
could enable broader clinical use of NPWT by dentists and introduce a novel,
cost-effective method to the existing literature.
