Knotless Suture for Primary Wound Closure Following Surgical Removal of Impacted Mandibular Third Molars - A Comparative Study.

Abstract

Introduction: Surgical extraction of impacted third molars is a common procedure in maxillofacial surgery. Wound closure is typically achieved using knotted sutures, which require time and may lead to knot-related complications. Knotless sutures, widely used in various surgical fields, offer potential benefits for intraoral applications. This study evaluated the clinical utility of knotless sutures following third molar surgery.

Materials and methods: A randomised split-mouth clinical study was conducted on 29 patients undergoing bilateral mandibular third molar removal. Each patient received two types of sutures: knotless polyglyconate barbed sutures and control group: knotted polyglactin 910 sutures. Parameters assessed included suturing time, pain and discomfort during suturing (via Visual Analogue Scale) and post-operative outcomes on day 7, soft tissue healing (Modified Landry Index), wound dehiscence, facial swelling and maximum interincisal opening.

Results: The knotless group showed significantly reduced suturing time and lower pain and discomfort scores. Improved soft tissue healing and reduced wound dehiscence were observed compared to the control group. No significant difference was found in facial swelling or mouth opening between the groups.

Discussion: Knotless sutures are effective for intraoral wound closure after third molar extraction. They reduce operative time, minimise patient discomfort and enhance wound healing, offering a viable alternative to conventional knotted sutures.