Effectiveness of knotless suture as a wound closure agent for impacted third molar – A split mouth randomized controlled clinical trial

• Published in: Journal of cranio-maxillo-facial surgery Vol. 48; no. 10; pp. 1004 - 1008
• Main Authors: Ramkumar Ceyar, K.A., Thulasidoss, Guru Prasad, Raja Sethupathy Cheeman, S., Sagadevan, Sembiyan, Panneerselvam, Elavenil, Krishna Kumar Raja, V.B.
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01-10-2020
• Subjects: Dentistry; Impacted third molar; Knotless suture; Minor oral surgery; Wound closure; Impacted third molar; Knotless suture; Minor oral surgery; Wound closure
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2020.07.014

This study was aimed to compare the effectiveness of 3-0 knotless barbed suture (polydioxanone) with 4-0 polyglactin 910 (vicryl) in achieving wound closure after impacted mandibular third molar surgery.
Patients with bilateral mandibular third molar impaction of similar difficulty index enrolled in the split mouth study. Wound closure was done using 3-0 knotless suture (30 × 30 cm) for the study group and 4-0 polyglactin 910 (vicryl) for the control group following extraction. Samples were allocated on the basis of simple randomization. The clinical outcome parameters that were measured were (1) time taken to achieve wound closure and hemostasis (2) postoperative mouth opening (3) swelling and (4) Pain. Data analysis involved descriptive statistics and paired t-tests (p < 0.05). IBM SPSS software (v.20.0) was used.
A total of 25 patients participated in the study (14 males and 11 females) with the mean age of 25.6 years. The mean time taken for wound approximation was 2.45 min and 4.1480 min (p-0.026) for the study and control groups respectively. The difference in mouth opening (p-0.015), VAS score(p-0.24), and swelling (p-0.041) were statistically significant on the first post-operative day in the study group than the control group indicating reduction in pain (p < 0.0001), swelling (p-0.033) and improvement in mouth opening (p < 0.0001) on seventh post-operative day in the study group compared to the control group.
Knotless suture is an effective alternative to conventional sutures for intra oral wound closure as it reduces suturing time, facilitates effective wound closure and minimises knot related complications.