Summary of findings 5. Primary versus secondary wound closure after the removal of mandibular wisdom teeth.
| Primary versus secondary wound closure after the removal of mandibular wisdom teeth | ||||||
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Population: adults with mandibular third molars requiring removal
Setting: oral surgery
Intervention: primary (complete) wound closure Comparison: secondary (partial) wound closure | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Secondary wound closure | Primary wound closure | |||||
| Alveolar osteitis (up to 1‐week follow‐up) | 43 per 10001 | 43 per 1000 (18 to 103) | RR 0.99 (0.41 to 2.40) | 375 (3 studies) |
⊕⊕⊝⊝ low2 | Insufficient evidence to claim either is better |
| Wound infection (up to 1‐week follow‐up) | 50 per 10003 | 13 per 1000 | RR 4.77 (0.24 to 96.34) | 82 (1 study) |
⊕⊝⊝⊝ verylow4 | Insufficient evidence to claim either is better |
|
Permanent altered tongue, chin, or lip sensation (more than 6 months) |
Not reported | |||||
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Adverse effects ‐ reactionary bleeding (up to 30 days) |
175 per 10001 | 72 per 1000 (19 to 257) | RR 0.41 (0.11 to 1.47) | 82 (1 study) | ⊕⊝⊝⊝ very low4 | Insufficient evidence to claim either is better |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio | ||||||
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GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect. | ||||||
1Medium event rate for control group used. 2Certainty of evidence downgraded twice due to studies at unclear or high risk of bias and imprecision in estimate. 3Event rate of 5% assumed. 4Certainty of evidence downgraded three times due to single study with imprecision.