Is Horizontal Mattress Suturing More Effective Than Simple Interrupted Suturing on Postoperative Complications and Primary Wound Healing After Impacted Mandibular Third Molar Surgery? (original) (raw)
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British Journal of Oral and Maxillofacial Surgery, 2012
Our aim was to assess the influence of sutureless and multiple-suture closure of wounds on postoperative complications after extraction of bilateral, impacted, mandibular third molars in 30 patients in a split mouth study. After the teeth had been removed, on one side the flap was replaced but with no suture to hold it in place (study side), and on the other side the wound was closed primarily with three sutures (control side). Recorded complications included pain, swelling, bleeding, and formation of periodontal pockets. The results showed that patients had significantly less postoperative pain and swelling when no sutures were used (p = 0.005). There were no signs of excessive bleeding or oozing postoperatively on either side. Six months postoperatively there was no significant difference in the depth of the periodontal pocket around the second molar.
journal of medical science and clinical research, 2018
Background: Lower third molar surgery remains one of the most common surgical procedure in oral and maxillofacial surgery. It has its own risks, and post-operative complications, that influence the recovery period, and affect a patient’s quality of life. This study aims to determine which of the two secondary closure techniques assessed is superior in improving wound healing, and reducing post-operative complications, following lower third molar surgery. Material & Methods: We carried out a prospective, randomised, double-blind, split-mouth controlled trial on 37 patients, who had bilateral impacted third molars of similar surgical difficulty, were recruited, with 34 successfully completing the study. We compared partial closure using one suture to the suture-less technique. Surgical sites were divided into two groups, Group A: one suture, and Group B: suture-less. Each patient received both treatments at the same time. During the first post-operative week, all patients were asked t...
International Journal of Oral and Maxillofacial Surgery, 2012
The aim of this prospective randomized study was to evaluate the effect of not using sutures on postoperative pain, swelling and trismus after lower third molar surgery. 80 patients with impacted lower third molars were referred for surgical extraction (42 males; 38 females; aged 18-38 years). The patients were randomly divided into two equal groups (sutures n = 40; suture-less n = 40). In the experimental group, the flaps were replaced without suturing. The control group was selected using the same criteria and treated under the same surgical protocol as the experimental group, except that the flaps were apposed using multiple sutures. Pain, swelling and trismus were evaluated at 24 h, 48 h and 1 week postoperatively in both groups. The operation time was found to be significantly longer in the multiple sutures group (p < 0.05). There was significantly less pain, swelling and trismus at 24 h and 48 h, respectively, in the suture-less group (p < 0.05). There was no significant difference between the two treatment groups in terms of pain, swelling and trismus, at 1 week postoperatively (p > 0.05). There is less postoperative pain, swelling and trismus with the suture-less technique in third molar surgery.
2021
Background Lower third molar extraction is usually associated with multiple stigmae that deters the patients in most cases to postpone or not seek appropriate surgical care. It is also one of the most feared procedure amongst dentists and dental students. However, evidence has been reported suggesting that the choice of suturing technique can have a profound effect on post-operation complications and thereby can improve the overall outlook and comfort of the patient. In the past, multiple techniques like Mattress, Continuous etc have been compared with tissue glues, staples however, a comparative clinical study amongst the simplest and most commonly used suturing techniques have not been reported. Material and Methods Sixty patients with impacted mandibular third molars fulfilled the inclusion criteria and were randomly divided into three groups of 20 each. All patients underwent third molar extraction and sutures were placed using different techniques – Simple Interrupted (Group A)...
Journal of Oral and Maxillofacial Surgery, 2011
Purpose: Pain, swelling, and trismus are the most common complications associated with third molar surgery. Several methods of alleviation of these complications have been described. The effect of single and multiple suture techniques on these complications was compared in the present study. Patients and Methods: All consecutive patients 18 years of age or older who had been referred for surgical extraction of their impacted teeth between January and December 2007 at the maxillofacial unit of the Aminu Kano Teaching Hospital were recruited and randomized into 2 groups. All selected participants underwent surgical extraction of their impacted teeth by the same surgeon under local anesthesia. The flaps in 1 group were closed by multiple sutures and those in the second group were closed by a single suture. Pain, swelling, and trismus were evaluated at postoperative days 1, 2, 3, 5, and 7. Descriptive and comparative statistical analyses were performed, and the results are presented. Significance was set at P Ͻ .05. Results: A total of 50 subjects participated in the present study. Both groups were comparable in terms of the age distribution (multiple suture group, 26.0 Ϯ 4.73 years; single suture group, 25.8 Ϯ 4.28 years, P ϭ .755), difficulty index (multiple suture group, 5.0 Ϯ 1.68; single suture group, 4.9 Ϯ 4.79; P ϭ .935), duration of surgery (multiple suture group, 29. 7 Ϯ 6.11 minutes; single suture group, 30.0 Ϯ 6.04 minutes; P ϭ .835), and baseline parameters such as facial width (multiple suture group, 10.0 Ϯ 1.32 cm; single suture group, 9.8 Ϯ 0.37 cm; P ϭ .115), mouth opening (multiple suture group, 4.5 Ϯ 1.32 cm, single suture group, 4.8 Ϯ 0.26 cm; P ϭ .165), and preoperative pain, which was 0 in both groups. Other comparable variables included impaction type (P ϭ .210) and indication for surgery (P ϭ .278). A statistically significant difference was found in the level of pain at postoperative days 1, 2, and 3 (P Ͻ .05). A similar significant difference was found in swelling and trismus (P Ͻ .05). At days 5 and 7, no significant differences were found between the 2 groups for all parameters of pain, swelling, and trismus (P Ͼ .05). Conclusion: Our study had a comparable distribution of age, gender, and operative variables, such as the pattern of impaction, preoperative difficulty index, and operative time between patients undergoing the 2 methods of closure. With that, our results have shown that the single suture closure technique was better than the multiple suture technique with regard to postoperative pain, swelling, and trismus.
SciDoc Publishers, 2021
Extraction of impacted teeth is one of the most common operations in oral and maxillofacial surgery. Assessment of the effectiveness of sutureless closure of wounds on postoperative complications after extraction of mandibular third molars. This is a Retrospective study conducted in the university setting. This study included patients who reported to private dental hospital for the removal of mandibular third molars. Inclusion criteria of this study included patients who required removal of mandibular third molars and exclusion criteria included patients with drug allergies and patients who are pregnant or currently lactating. Data was collected and tabulated in excel. Data was analysed using IBM SPSS Statistical Analyzer(23.0 version) Frequency distribution and descriptive analysis were carried out. The association between the variables was analysed and assessed using Pearson Chi-square test. P value < 0.05 was considered to be statistically significant. Patients experienced less postoperative complications in wound closure without suture compared to wound closure with suture. Secondary closure has significant advantage over primary closure based on postoperative pain and swelling.
TURKISH JOURNAL OF MEDICAL SCIENCES, 2013
Introduction Operative extraction of impacted third molars is one of the most frequently performed procedures in oral surgical practice and is associated with various postoperative sequelae. The most common postoperative complaints include pain, trismus, swelling, and wound dehiscence that influence the patients' quality of life in the week following surgery (1,2). Intraoral, extraoral suture, and flap techniques affect these postoperative complications (3-7). The overall purpose of this study was to answer the following clinical question: Among patients having mandibular third molars removed, were the complications and side effects noted by using the 3-cornered flap technique higher when compared with the complications and side effects found with the modified triangular flap? The investigators hypothesized that there was no difference in the rate of complications and postoperative side effects between the 2 study groups. The specific aims of this study were: 1) to estimate the wound dehiscence, 2) to identify the postoperative pain by using a visual analog scale (VAS), 3) to have postoperative swelling measured by one of the investigators, and 4) to measure the mouth opening, taken the maximum distance between maxillary and mandibular central incisors by a ruler following third molar surgery in both flap groups. 2. Materials and methods 2.1. Study design and sample The investigators designed and implemented a randomized, prospective, single-blind clinical trial. The study population was composed of subjects presenting to the Department of Oral and Maxillofacial Surgery for evaluation and management of impacted mandibular third molars between January 2011 and July 2011. The inclusion criteria consisted of the presence of bilateral, symmetrical, vertically bony impacted third molars on panoramic radiographs. The patients selected had no history of medical illness or medication that could influence the course of postoperative wound healing or alter their wound healing after surgery. Patients were excluded from randomization if they had a preexisting abscess or cellulitis, acute pericoronitis, or preexisting conditions associated with their third molars. Those who required antibiotics for some other reason (such as prophylaxis for endocarditis) were also excluded, as were those who Aim: To estimate the effects of flap design on wound dehiscence and the postoperative side effects after the extraction of bilateral impacted mandibular third molars. Materials and methods: This study was designed as a randomized, clinical trial composed of a sample of subjects ≥18 years of age who required surgical extraction of the mandibular third molars. The predictor variable was flap type. A 3-cornered flap was used on one side and a modified triangular flap was used on the other. The primary outcome variable was wound dehiscence. The secondary outcome variables were pain, swelling, and trismus. Other variables were demographic and operative. Descriptive, bivariate statistics were computed. Significance was set at P < 0.05. Results: Forty patients who required removal of bilateral impacted third molars were included. There were no significant differences regarding wound dehiscence and postoperative side effects between the 2 flap techniques. Conclusion: Both flap designs obtained similar short-term outcomes in mandibular third molar surgery.
2016
The surgical removal of an impacted mandibular third molar is considered as one of the most frequent minor procedures performed in oral and maxillofacial surgery. The purpose of this study is to clinically compare the post-operative sequelae such as pain, swelling and trismus following two different flap techniques in the surgical removal of impacted mandibular third molars. This study was conducted on 40 patients having bilateral impacted mandibular molars. The patients were then randomly allocated to any of the two groups. In 1st group each patient, the incision margins were joined and sutured, without closing the wound, on one side, seeking healing by second intention (Technique 1). On the contralateral side the flap was repositioned to allow healing by first intention (Technique 2). The Technique 1 proved more successful in preventing post-surgical sequelae of impacted third molar removal. Post-operative analysis showed increased amount of pain, swelling and trismus in group 2 a...
Al-Rafidain Dental Journal, 2016
Aims: The aim of the study is to determine the effects of different suturing techniques on post-operative complications (pain and swelling) following the removal of impacted lower wisdom teeth. Materials and Methods: Sixty medically fit patients were randomly selected with an age range between 16-42 years of both sexes. They were divided into 3 groups. These patients had impacted lower third molars indicated for surgical extraction. The first group comprised of twenty patients, the flap would be closed by simple interrupted suturing technique, and in the second group (20 patients) by vertical mattress suturing technique, and anchoring suture techniques for the third group (20 patients). All groups will be compared by clinical assessment to determine post-operative complications including pain and swelling. Results: In all treatment groups, pain (on VAS) reached its peak on the first post-operative day then faded away. In all groups, swelling was most severe in the first post-operative day and gradually decreased, with the anchor suturing technique showing significant difference of swelling at day three Conclusions: Changing the method of suturing appear to have no effect on the degree of pain, swelling following surgical removal of impacted mandibular third molars.