Estimation of time utilized in suturing of oral flaps post-surgical wisdom teeth removal using Negus knot pusher instrument (a comparative study)

Noor Sulaiman,Ziad Deleme,Saif Ali

doi:10.14295/bds.2021.v24i4.2645

Abstract

Wisdom teeth were the most common teeth affected among the rest of the teeth, these teeth need accurate evaluation and diagnosis, surgical removal of impacted wisdom needs time for incision, bone removal and suture, so the use of any instrument helps to reduce this time is essential. Objective The objectives of this study were to estimate the time needed for the suture of oral flaps post-surgical removal of the lower wisdom teeth by using Negus knot pusher and compare it with the time used for stitching in conventional manual holding single stitching. Material and Methods: Data had been collected from thirty patients through history, clinical examination and radiographic assessment, followed by classical surgical removal performed on the same principles for all patients, at the suture level patients divided arbitrarily into two groups, control group 15 patients and 15 patients Negus pusher group, using Negus knot pusher, which is usually used to hold the stitch and stop bleeding post tonsillectomy operations by ligation, time elapsed for suturing with knot tying is calculated for both groups. Results: Among the 30 patients incorporated in the clinical study, control group mean was (1 minutes and 11 seconds and 70 milliseconds) while for the pusher group was (1 minutes and 32 seconds and 57 milliseconds), the comparison by means of T-test was not significant with the (0.424) value. Conclusion: the Negus pusher instrument can be used for the knotting stiches post wisdom teeth removal as an auxiliary tool and the time can be shortened by the use of a modified handling technique and more satisfaction for patients. Keywords Time; Suturing; Wisdom teeth; Negus knot pusher.

Highlights

Third molar extraction is frequent minor intraoral surgical procedure [1]
The Negus Knot Pusher instrument is used for vascular bundle ligation in the tonsillectomy procedure to control intraoperative bleeding and to reduce postoperative bleeding, so that it can reach a deep point in the retromolar trigon or oropharyngeal area and for this reason we choose using this instrument in our study and get benefit of time elimination during operative work specially in cases operated under local anaesthesia and need intraoral suturing with minimal time as possible
This study includes thirty cases of both male and female presented to the Oral and MaxFax Departments complaining of ache in either the lower right or left quadrant of the jaw with partially or completely affected lower third molar after taking clinical and radiographic history (Periapical radiography, OPG and CBCT) Evaluation of the difficulty of the case according to Bell and Gregory classification was carried out, the inclusion criteria for the Estimation of time utilized in suturing of oral flaps post-surgical wisdom teeth removal using Negus knot pusher instrument incomplete bone covering of the mandibular third molars with “Class II or III and position A, B or C,” on the periapical radiography

Summary

Introduction

Third molar extraction is frequent minor intraoral surgical procedure [1]. Most common causes for wisdom teeth removal comprise pathological dental caries, opercular tissue inflammation, periodontal problems, cystic pathology, and orthodontic problems. Post-surgical pain and edema is important factors in surgical wound curing, and use of minimal sutures with smaller diameters or utilizing anchor suture is recommended. Commercial node pusher tools are rod-shaped and necessitate a helper to grasp one end of the suture as the surgeon pushes the node inferiorly [17]. The Negus Knot Pusher instrument is used for vascular bundle ligation in the tonsillectomy procedure to control intraoperative bleeding and to reduce postoperative bleeding, so that it can reach a deep point in the retromolar trigon or oropharyngeal area and for this reason we choose using this instrument in our study and get benefit of time elimination during operative work specially in cases operated under local anaesthesia and need intraoral suturing with minimal time as possible

Methods

Results

Discussion

Conclusion