Effectiveness of Knotless Suture as A Wound Closure Agent for Impacted Third Molar

Naresh  Kumar; Anwar  Ali; Tivishna  Bai; Kiran .; Gobind  Ram; Roma .

doi:10.54112/bcsrj.v6i1.1527

Authors

Naresh Kumar Department of Oral and Maxillofacial Surgery, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences Dow University of Health Sciences Karachi, Pakistan
Anwar Ali Department of Oral and Maxillofacial Surgery, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences Dow University of Health Sciences Karachi, Pakistan
Tivishna Bai Department of Oral and Maxillofacial Surgery, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences Dow University of Health Sciences Karachi, Pakistan
Kiran . Department of Oral and Maxillofacial Surgery, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences Dow University of Health Sciences Karachi, Pakistan
Gobind Ram Department of Oral and Maxillofacial Surgery, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences Dow University of Health Sciences Karachi, Pakistan
Roma . Department of Operative Dentistry & Endodontics, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences Dow University of Health Sciences Karachi, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i1.1527

Keywords:

Impacted third molar, Knotless sutures, Wound closure, Oral surgery, Post-operative swelling, Pakistan

Abstract

Impacted third molar extraction is a common surgical procedure performed by oral and maxillofacial surgeons, often requiring effective wound closure techniques. Conventional sutures have been widely used; however, knotless sutures have emerged as an alternative method, potentially offering faster wound closure and reduced post-operative complications. This study evaluates the effectiveness of knotless sutures as a wound closure agent compared to conventional sutures in impacted third-molar surgeries in the Pakistani population. Objective: To compare the outcomes of knotless sutures versus conventional sutures regarding wound closure time and post-operative swelling in impacted third-molar surgeries. Methods: A randomized controlled trial was conducted at the Department of Oral & Maxillofacial Surgery, Dr. Ishrat Ul Ebad Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan. 72 patients undergoing impacted third molar extraction were randomly allocated into Group A (knotless sutures) and Group B (conventional sutures), with 36 patients in each group. Primary outcomes included wound closure time (measured in minutes) and post-operative swelling (measured in millimeters) at 1-hour and 72-hour intervals. Data were analyzed using SPSS version 23, and statistical significance was set at p≤0.05. Results: The mean age of participants was 26.14 ± 4.66 years in Group A and 24.50 ± 4.39 years in Group B. Mean wound closure time in Group A was significantly lower (2.78 ± 0.90 minutes) compared to Group B (4.47 ± 1.30 minutes, p=0.0001). Swelling at 1 hour post-operatively was significantly lower in Group A (42.69 ± 4.82 mm) than in Group B (46.22 ± 4.46 mm, p=0.002). Similarly, at 72 hours, swelling was lower in Group A (34.75 ± 4.80 mm) compared to Group B (40.80 ± 6.56 mm, p=0.0001). Conclusion: Knotless sutures improved wound closure efficiency and reduced post-operative swelling compared to conventional sutures in impacted third-molar surgeries. These findings support adopting knotless suturing techniques in oral surgical procedures to enhance clinical outcomes and patient comfort.

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References

Blondeau F, Daniel NG. Extraction of impacted mandibular third molars: Postoperative complications and their risk factors. J Can Dent Assoc. 2007; 73(4):325.

Khan M, Rahman M, Ullah F, et al. Pattern and prevalence of impacted third molars in a Pakistani population. J Pak Med Assoc. 2019; 69(10):1445-50.

Renton T, Hankins M, Sproate C, McGurk M. A randomized controlled clinical trial to compare the effect of suture-less and sutured wound closure after third molar removal. Int J Oral Maxillofac Surg. 2001; 30(3):271-5.

Bortoluzzi MC, Capella DL, Barbieri T, et al. A randomized clinical trial comparing two suture techniques for wound closure after third molar removal. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109(3):1-6.

Chuang SK, Perrott DH, Susarla SM, Dodson TB. Age as a risk factor for third molar surgery complications. J Oral Maxillofac Surg. 2007; 65(9):1685-92.

Al-Belasy FA. The effect of suturing techniques on the incidence of alveolar osteitis following the removal of impacted mandibular third molars. J Oral Maxillofac Surg. 2007; 65(5):909-13.

Kim J, Kim Y, Yun PY, Lee BS. Effect of different wound closure techniques on postoperative complications after mandibular third molar surgery. J Oral Maxillofac Surg. 2019; 77(9):1866-72.

Landwehr JM, Taxin Z, Grosskopf G, et al. The role of sutures in oral surgery: A comparative study. J Oral Surg. 2020; 78(2):110-9.

White RP, Shugars DA, Shafer DM, et al. Recovery after third molar surgery: Clinical and health-related quality of life outcomes. J Oral Maxillofac Surg. 2003; 61(5):535-44.

Su N, van Wijk AJ, Berkhout E, et al. Predictors of postoperative pain and swelling after third molar extraction. J Oral Maxillofac Surg. 2021; 79(3):615-24.