## 4 Discussion  
The extraction of the mandibular third molar ranks among the most common procedures in oral and maxillofacial surgery. Consequently, reducing postoperative complications holds substantial importance from medical, legal, and financial perspectives. Common postoperative complications include pain, trismus, and swelling [26]. The detection of these complications can be achieved via a number of different methods. Pain is a complex, subjective experience characterized by two distinct dimensions: sensory and affective. This dissociation is observed across various painful somatic conditions. However, the majority of experimental studies have focused primarily on the sensory aspect of pain, asking subjects to report only the intensity of pain using VAS [27]. Both objective and subjective methods exist for measuring trismus. Maximum mouth opening serves as a widely utilized objective measure for assessing trismus, representing the maximum distance between the edges of the upper and lower incisors [28]. Studies in the literature have documented the use of both subjective methods, such as the verbal rating scale and the visual analogue scale, and objective techniques, including 3D stereophotography, MRI, and metric measurements, to assess swelling after impacted third molar surgery. Among these methods, metric measurements are commonly used due to their simplicity, ease of use, cost effectiveness, and time efficiency [29; 30]. For these reasons, these methods were used in the evaluation of complications in this study. This is the first study to compare the primary and secondary closure techniques for L-PRF in impacted lower third molars. We compared primary and secondary closure techniques to determine which would have a greater effect on postoperative complications, or which would mask the potential benefits of L-PRF. There was no difference between the two closure techniques in terms of mouth opening, facial measurements, and use of rescue analgesics. At 6 h, more pain was observed on the primary closure side; on the other hand, the decrease in postoperative pain at the end of the first week was greater on the primary closure side. In the present study, there was only a difference in the facial measurements when compared by gender, and it was observed that the facial measurements of men were higher during the preoperative period and on the second and seventh postoperative days. \begin{table}
\begin{tabular}{l c c c c c} \hline \hline  & \multicolumn{4}{c}{**Gender**} \\ \cline{2-5}  & \multicolumn{2}{c}{**Female**} & \multicolumn{2}{c}{**Male**} & \(p\) \\ \cline{2-5}  & **Mean** & **Sd** & **Mean** & **Sd** & \\ \hline Preoperative mouth opening & 44.48 & 6.70 & 47.46 & 5.94 & 0.191 \\
2 nd-postoperative-day mouth opening & 24.96 & 6.69 & 29.15 & 10.24 & 0.146 \\
7 th-postoperative-day mouth opening & 36.96 & 6.95 & 41.54 & 9.15 & 0.100 \\ Preoperative face measurements & 106.74 & 6.68 & 114.85 & 6.85 & **0.001 \({}^{*}\)** \\
2 nd-postoperative-day face & 111.74 & 6.33 & 120.00 & 8.42 & **0.002 \({}^{*}\)** \\ measurements & 108.48 & 8.04 & 115.46 & 8.13 & **0.018 \({}^{*}\)** \\
6 th-hour VAS & 5.83 & 2.64 & 5.85 & 2.27 & 0.982 \\
12 th-hour VAS & 4.09 & 2.73 & 5.38 & 3.62 & 0.232 \\
18 th-hour VAS & 4.22 & 2.81 & 5.00 & 3.14 & 0.447 \\
24 th-hour VAS & 3.65 & 2.25 & 4.15 & 2.34 & 0.530 \\
2 nd-day VAS & 3.13 & 1.71 & 3.15 & 2.76 & 0.975 \\
3 rd-day VAS & 1.61 & 1.53 & 2.31 & 1.75 & 0.220 \\
4 th-day VAS & 0.87 & 1.14 & 2.08 & 1.85 & **0.020 \({}^{*}\)** \\
5 th-day VAS & 0.61 & 0.94 & 1.31 & 1.75 & 0.201 \\
6 th-day VAS & 0.48 & 0.85 & 1.38 & 2.18 & 0.172 \\
7 th-day VAS & 0.35 & 0.78 & 1.08 & 1.71 & 0.166 \\ Rescue analgesic number & 8.17 & 5.20 & 9.92 & 6.28 & 0.375 \\ \hline \hline \end{tabular} \({}^{*}p<0.05\), independent groups \(t\) test.  
\end{table} 
Table 3: Comparison of mouth opening, face measurement, VAS scores, and rescue analgesic number according to gender. The main reason for this difference, apart from the gender difference causing swelling, is that men have a longer face.