A Clinico-Microbiological Comparison of Antibacterial-Coated and Non-coated Polyglactin 910 Sutures in Extraction Sockets: Prospective, Split-Mouth, Randomized, Triple-Blinded Study.

Abstract

Introduction: Despite being a ubiquitous procedure in oral surgery, tooth extraction, including impacted third molars, carries the potential for postoperative complications such as suture site infections (SSIs). These SSIs occur with a frequency of approximately 5% and typically fall within the "clean-contaminated" surgical category, where triclosan-coated sutures have demonstrated a reduction in incidence. However, the intraoral environment presents a unique microbial landscape, raising the question of whether these benefits translate to the specific context of extraction sockets. Therefore, this investigation aims to conduct a comparative analysis, examining both clinical and microbiological aspects, to evaluate the antibacterial efficacy of plain polyglactin 910 sutures and triclosan-coated polyglactin 910 sutures in extraction sockets post-surgery.

Material methods: Assessing effectiveness of triclosan sutures in reducing suture site infections, a split-mouth study was conducted with 111 patients undergoing multiple extractions (222 sites). Each patient received triclosan suture on one site and plain suture on the other. Suture handling, infection rates, pain levels, and healing were evaluated on days 3 and 7 post-extraction. Bacteria on the sutures were also identified and quantified.

Results: The study found that triclosan-coated sutures significantly improved socket healing, reduced suture site infections (SSIs), and decreased bacterial colonization compared to plain polyglactin 910 sutures on day 3 when compared to day 7. The study suggests that triclosan's antibacterial properties reduce bacterial colonization on sutures, leading to improved clinical outcomes.

Conclusion: This study demonstrates triclosan-coated sutures reduced infection and inflammation in dental extractions compared to conventional sutures, likely due to decreased bacterial colonization.