Single blind, randomized study comparing clinical equivalence of Trusilk® and Mersilk® silk sutures for mucosal closure following surgical removal of mesioangular impacted mandibular third molar

Abstract

Background: Mesioangular impacted mandibular third molar is a common dental anomaly, for which surgical extraction is required. Post-surgery closure of mucosa reduces the prevalence of pain and other surgery-associated complications. We compared tissue reaction/inflammation after 3 and 7 days of mucosal closure with Trusilk® and Mersilk® silk sutures, following impacted mandibular third molar removal. Methods: This multicenter, prospective, two-arm, parallel-group, randomized (1:1), single-blind study (July 2020-November 2021) included subjects (Trusilk®, n=65 and Mersilk®, n=64), requiring mucosal suturing following impacted mandibular third molar removal. The primary endpoint, incidence of pain, swelling and trismus at the extraction area on post-surgery day 3 and 7 was evaluated. The secondary endpoints, incidence of tissue reaction, wound infection, suture loosening, other complications, operative time, amount of anesthesia, intraoperative suture handling, time needed for complete wound healing and suture removal, and adverse events were also recorded. Results: Socio-demographic and intra-oral characteristics were comparable between the groups. In Trusilk® and Mersilk® groups, a gradually decreasing pain score, starting from day 0 post-surgery (42.17±22.38 vs. 45.97±22.20) to day 7 (8.40±11.93 vs. 8.28±12.13) to day 30 (1.98±0.89 vs. 1.75±0.76) was witnessed. After the surgery, 21.54% and 17.19% subjects in Trusilk® and Mersilk® groups, respectively, had no post-operative swelling, while at the last two visits none of the subjects had swelling. Non-significant difference in wound infection, suture loosening, wound healing, bleeding, taste changes, operative time, amount of anesthesia, intraoperative suture handling, and time needed for complete wound healing and suture removal was noted among the groups. No suture-related adverse events were recorded. Conclusions: The results indicated that the Trusilk® and Mersilk® silk sutures are clinically equivalent and can be used for mucosal closure after removal of an impacted mandibular third molar with a minimal rate of pain, swelling and trismus. Clinical Trial Registry of India Registration: CTRI/2020/03/024100 (20/03/2020)

Microbiological and Clinical Assessments of Suture Materials and Cyanoacrylate Application in Impacted Third Molar Surgeries: A Scoping Review

“…This held true for assessments made at both the 72-hour and 7-day post-surgery marks, as well as during all follow-up visits. Likewise, there were no significant differences observed in the rates of wound infection, suture loosening, total procedure duration, anesthetic dosage, intraoperative suture management variables, the time required for full wound healing and suture removal, or the occurrence of additional complications such as bleeding, alterations in taste, or other adverse events between the two suture groups [44].…”

“…The studies were controlled intervention [39][40][41][42][43][44][45][46][47][48][49][50][51][52], observational cohort, and crosssectional studies [22,53,54].…”

Effects of modified triangular flap for third molar extraction on distal periodontal health of second molar: A randomized controlled study

“…Then, a full-thickness mucoperiosteal flap was created, distal mild osteotomy (1/3 of dental crown height) [ 19 ] and/or tooth sectioning were performed by using a high-speed elevation turbine handpiece combined with a minimally invasive extraction to remove the resistance. Last, tension-free interrupted 4–0 non-absorbable silk suturing (Ethicon, Johnson & Johnson, USA) [ 20 ]. Instruct the patient about routine precautions after surgery.…”

Natural polymers in wound healing: From academic studies to commercial products

“…59,60 Col-containing wound dressings accelerate healing by creating a moist and comfortable environment, and by inactivating matrix metalloproteinases. 61 Col-containing wound dressings also act as anti-inflammatory, analgesic and angiogenesis enhancers, and by changing the Trusilk ® suture was clinically equivalent to the Mersilk ® suture and no differences were observed 2022 57 microenvironment of the wound, stimulation of the healing cascade occurs. 62,63 Due to the hydrophilic nature of Col-containing wound dressings, exudates rich in growth factors and matrix metalloproteinases can be adsorbed.…”