Effect of One-Suture and Sutureless Techniques on Postoperative Healing After Third Molar Surgery

Alkadi, Saleh; Stassen, Leo F A

doi:10.1016/j.joms.2018.12.001

Cited by 18 publications

(21 citation statements)

References 61 publications

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“…In our study, no significant difference was found up until Day 31. Another randomized controlled split-mouth study on 35 patients comparing a single stitch behind the second molar against no sutures found greater pain on the non-sutured side from Day 5 onwards, but this was non-significant before Day 5 [ 6 ]. Finally, Mahat et al [ 5 ] performed a randomized study of 48 patients with either hermetic sutures with separate stitches or without suture, showing that pain was statistically higher for the Suture group only on Day 1.…”

Section: Discussionmentioning

confidence: 99%

“…We found no between-group differences for trismus, painkiller consumption, postoperative complications and edema, similarly to Mahat et al [ 5 ]. In contrast, Alkadi et al observed significantly better healing up to one month on the sutured side, but without difference in edema and bleeding between the two techniques, evaluated up to Day 7 [ 6 ]. However, edema was significantly higher in the Suture group in the Mahat et al study [ 5 ] when measured between the mandibular angle and the lateral cantus, whilst edema measured between the tragus and the labial commissure was not significantly different.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, although they found no significant difference in postoperative edema, pain or infection, there was a tendency for incomplete closure in sutured patients. Subsequent studies have compared operating site closure techniques following impacted wisdom tooth extraction [ 4 – 6 ]. However, none has evaluated pain, edema, trismus, complications, painkiller use and quality of life beyond 7 days postoperatively in a large cohort.…”

Section: Introductionmentioning

confidence: 99%

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Sutureless socket technique after removal of third molars: a multicentric, open, randomized controlled trial

Takadoum

Douilly²,

Boutray³

et al. 2022

BMC Oral Health

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Background Although wisdom-tooth extraction is a routine intervention, the postoperative period remains marked by local inflammation classically manifesting as pain, edema and trismus. Furthermore, there is no consensus on the best operative techniques, particularly for the mucosal closure stage on impacted mandibular wisdom teeth. Methods This parallel, randomized, non-blinded study compared pain following removal of impacted third molars, with and without sutures. Patients were electronically allocated 1:1 to extraction with versus without sutures. Patients ≥ 14 years’ old scheduled for extraction of four impacted wisdom teeth under general anesthesia at three French hospitals were eligible for inclusion. Exclusion criteria included taking antiplatelet agents or anticoagulants, coagulation disorders or immunosuppression, and planned orofacial surgical procedures or emergency pain/infection. The primary objective was pain evaluated by Visual Analogue Scale on Day 3. Secondary outcomes were edema, trismus, healing, complications, painkiller consumption and quality of life on Day 3 and 31. Results Between June 2016 and November 2018, 100 patients were randomized. Finally, 44 patients in the Suture group and 50 patients in the Without Suture group were analyzed. Mean age was 16.5 years and 66.6% of patients were female. After adjustment on center, age and smoking, no statistical difference was seen between groups for pain on Day 3 (p = 0.904). No differences were seen for swelling, trismus, consumption of painkillers, healing, complications or quality of life. Smokers had a 3.65 times higher complications rate (p = 0.0244). Conclusions Sutureless removal of third molars is thus a reliable technique without negative consequence on outcomes, and allows shorter operating time. Smoking is a risk factor for postoperative complications. Trial registration www.clinicaltrials.gov (NCT02583997), registered 22/10/2015

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sutureless socket technique after removal of third molars: a multicentric, open, randomized controlled trial

Takadoum

Douilly²,

Boutray³

et al. 2022

BMC Oral Health

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“…Once the extraction has been carried out, the flaps will be sutured. Certainly some anatomical variants, such as particularly long or curved roots and proximity to the mandibular canal, can make the extraction for the oral surgeon more complex [12,49,50,56,57,58,59,60,61,62,63,64,65,66,67].…”

Section: Methodsmentioning

confidence: 99%

Antibiotic Prophylaxis on Third Molar Extraction: Systematic Review of Recent Data

et al. 2019

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The aim of this paper was to highlight the most widely antibiotic protocols applied to the dental field, especially in the surgical treatment of impacted wisdom teeth. Once these protocols were screened, all the possible advantages or disadvantages for each drug and each posology were recorded in this review. In recent years, the need to use these protocols has been debated in the literature. The data obtained by this review underlined how antibiotic protocols applied to oral surgery treatments only included surgeries performed on patients who did not present other systemic pathologies. The first literature review obtained 140 results, and then after the application of the inclusion criteria, 12 papers were selected. The results showed that the most commonly used protocol involved the use of penicillin and clavulanate, obtaining safe clinical and prophylactic results in the management of infections. This widely used protocol seems to guarantee high predictability and safety. The presented review highlights the current possibility of antibiotic resistance affecting patients due to drug misuse. Further clinical studies are required to state specific guidelines; however, oral surgeons involved in third molar surgery should evaluate the local and general health conditions of the patients before suggesting any drug measures for patients.

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“…Extraction of impacted mandibular horizontal third molars is the most common surgery performed by oral surgeons. Surgical procedures may vary depending on the ap design and cutting instrument, with or without the drainage or suturing technique [1][2][3][4] , but most oral surgeons may experience the extraction on the basis of the instructor's procedure. Therefore, the advantages or disadvantages of the surgical procedure are rarely analyzed systematically.…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of Two Flap Designs for the Extraction of Impacted Mandibular Horizontal Third Molars: a Multicenter Randomized Control Trial

Naruse

Rokutanda

Inokuchi³

et al. 2021

Preprint

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Most patients experience postoperative complications caused by the extraction of impacted mandibular horizontal third molars. The aim of the present study was to compare the effects of two flap designs as a refinement on the reduction of postoperative complications. One hundred eighty-eight patients with impacted mandibular horizontal third molars were included in this single-blind, multicenter, randomized control trial. The allocation was determined using a modified envelope flap (mEF) and triangular flap (TF) at 1:1 by the data manager. Postoperative complications (pain, hemorrhage, nerve paralysis, dry socket, and infection) and operation time were assessed 7 ± 1 days after surgery. In all cases, postoperative pain was significantly lower in the mEF group (P<0.05). In the subgroup analysis, postoperative pain was significantly lower in patients with low difficulty (IA, IIA, IIA, IB), which were classified by G.B. Winter classification (P<0.05). Other factors were not significantly associated with the flap design. Our study suggests that mEF resulted in less postoperative pain with a low difficulty of impacted mandibular horizontal third molars. However, the evidence at present is not sufficient to suggest the use of either flap design.

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Effect of One-Suture and Sutureless Techniques on Postoperative Healing After Third Molar Surgery

Cited by 18 publications

References 61 publications

Sutureless socket technique after removal of third molars: a multicentric, open, randomized controlled trial

Sutureless socket technique after removal of third molars: a multicentric, open, randomized controlled trial

Antibiotic Prophylaxis on Third Molar Extraction: Systematic Review of Recent Data

Comparative Analysis of Two Flap Designs for the Extraction of Impacted Mandibular Horizontal Third Molars: a Multicenter Randomized Control Trial

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