Year : 2022

Volume : Volume 13

Issue : Issue 5

Address for correspondence :
Sanjana Arora,
jambhsaru24@gmail.com

Abstract

Introduction: Teeth impaction is defined as a tooth which is prevented from erupting into its normal position properly within the expected/estimated time due to some kinds of physical barrier within the path of eruption. Third molar/wisdom teeth impactions are commonly associated with several acute or chronic pathological symptoms such as pain, infection, caries, periodontal disease, root resorption, bone loss, cyst formation, and benign tumors. All of these changes justify its removal. Pain, swelling, reduced mouth opening, and temporary inability to work are the commonly recognized and inevitable post-operative consequences following surgical
extraction. Damage to the capillaries and the release of inflammatory cytokines as a result of surgery lead to increased permeability of vessels and accumulation of serosanguineous fluid and exudate. Suturing the flap back to its position has an advantage of promoting healing by primary intention, convenient maintenance of effective oral hygiene, and hemorrhage control. However, suturing creates a
one-way valve that allows food debris to enter the socket but does not allow them to escape. Large amount of data exists regarding the advantages of sutureless technique after third molar surgery such as less pain, swelling, and trismus with comparatively few undesirable effects. Thus, we are interested to compare the effects of multiple sutures and sutureless technique in patients referred for third molar
surgical extraction with the objective to evaluate the effectiveness of both techniques in reducing post-operative complications. This would help us to predict the outcomes on oral health-related quality of life and treatment cost for our patients/population. Materials and Methods: This was a prospective, randomized controlled trial performed on humans. Fifty-two healthy patients were included
in the study who were having complete or partially impacted third molar. These patients were then divided into two groups, namely, multiple sutures (n = 26) and sutureless (n = 26) with the help of computer automated ran domized table. Exclusion criteria include those patients with systemic diseases, pregnant and lactating women, any known contraindication to the drugs or anesthesia in the surgical procedure, and patients with pericoronitis who were currently under antibiotics regimen within 3 days. After seeking ethicalapproval from the Institutional Ethical Board, patients were explained about the surgical procedure and a written informed consent was obtained regarding research. Results: There were no significant differences in demographic, anatomic, operative, and baseline patient characteristics except for the number of local anesthetic blocks which were more in the sutureless group (P = 0.02) . The results of the present study depicted that swelling was significantly more in the multiple sutures group when measured from the gonion to
lateral canthus on all post-operative days (P = 0.002−0.004). Although mean duration of surgery, swelling as measured from tragus to commissure, trismus, number of analgesics consumed, and complications were more in the multiple sutures group, the difference was not statistically significant. The mean number of analgesics consumption was higher in Group 1 except for the 5th and 6th post-operative
day. An equal number of analgesics was consumed in the 5th post-operative day by both the groups. Since the number of analgesics taken was greater in the 2nd post-operative day among both the groups, the frequency decreased till the 7th day. On the whole, there was no statistically significant difference in analgesic consumption between two groups. Complications such as angular cheilitis,
rashes, diarrhea, fever, erythema, and fainting were seen in a greater number of patients in Group 1. There was no statistically significant relation between occurrence of complications between
the two groups (P = 0.33). Limitations of daily activities to work were reported only in the multiple sutures group. Conclusion: This study has shown that the sutureless technique can be used as an alternative to those performed through standard incisions. Hence, the sutureless technique is a simple and viable option for minimizing the postoperative morbidity associated with inflammatory sequelae after the third molar surgery.
Keywords: Complications, Multiple sutures, Sutureless, Third molar surgery