Clinical and microbiological comparison of knotless/barbed and silk sutures for impacted third-molar surgery.

Abstract

Several types of suture materials are available for oral surgery. However, the most used non-resorbable suture in oral surgery is 3/0 silk. The aim of the present study was to compare the effectiveness of knotless/barbed sutures with silk sutures during the postoperative period after the third molar surgery in terms of clinical and microbiological parameters. The study comprised 38 patients who underwent surgical extraction of a mandibular impacted third molar. The patients were divided into two groups. The mucoperiosteal flap was closed using 3/0 knotless/barbed sutures for the test group and 3/0 silk sutures for the control group. The duration of suturing was recorded during surgery. Pain level, postoperative edema, and trismus were measured at 3 and 7 days after surgery. The status of plaque formation on the sutures was scored using the Plaque Index at 3 and 7 days after the surgery. At 7 days, the suture materials were removed and submitted to the laboratory for microbiological analysis. The level of pain during suture removal was also recorded by a Visual Analog Scale. The duration of suturing in the barbed sutures group was found significantly lower than in silk sutures (P<0.05). There was no significant difference between the suture types in terms of trismus and edema at 3 and 7 days after surgery (P>0.05). On the third day after surgery and during suture, removal pain scores were statistically significantly lower in the barbed suture group than in the silk suture group (P<0.05). The Plaque Index values of the barbed sutures were statistically significantly lower than that of the silk sutures at 3 and 7 days after surgery (P<0.05). Aerobic, anaerobic, and aerobic/anaerobic mean colony forming units (CFUs) were statistically significantly lower in the barbed suture group than in the silk suture group (P<0.05). Barbed sutures increase the ease of operation and patient comfort with less postoperative pain than silk sutures. Additionally, less plaque accumulation and lower bacterial colonization were found on the barbed/knotless sutures than on the silk sutures.