The Use of Three Different Suturing Techniques for Wound Closure of Mucoperiosteal Flaps After Surgical Removal of Impacted Lower Wisdom Teeth (Comparative Study)

Ziad Delemi

doi:10.33899/rden.2016.164143

Abstract

Aims: The aim of the study is to determine the effects of different suturing techniques on post-operative complications (pain and swelling) following the removal of impacted lower wisdom teeth. Materials and Methods: Sixty medically fit patients were randomly selected with an age range between 16–42 years of both sexes. They were divided into 3 groups. These patients had impacted lower third molars indicated for surgical extraction. The first group comprised of twenty patients, the flap would be closed by simple interrupted suturing technique, and in the second group (20 patients) by vertical mattress suturing technique, and anchoring suture techniques for the third group (20 patients). All groups will be compared by clinical assessment to determine post-operative complications including pain and swelling. Results: In all treatment groups, pain (on VAS) reached its peak on the first post-operative day then faded away. In all groups, swelling was most severe in the first post-operative day and gradually decreased, with the anchor suturing technique showing significant difference of swelling at day three Conclusions: Changing the method of suturing appear to have no effect on the degree of pain, swelling following surgical removal of impacted mandibular third molars.

Highlights

The surgical removal of impacted third molars is a common procedure associated with a diversity of technique and anecdotalAl – Rafidain Dent J Vol 17, No1, 2017 opinion
(6) The surgical removal of third molar teeth may result in a number of complications including pain, swelling, bleeding, alveolar osteitis or nerve dysfunction
The simple loop suture is a very widely used suturing technique usually preferred by surgeons evaluating the effect of third molar removal on the periodontal health of the adjacent second molar as shown in Figure [1]. [11]

Summary

INTRODUCTION

Al – Rafidain Dent J Vol 17, No1, 2017 opinion. Most surgeons agree that surgical time, surgical trauma, and difficulty of impaction are important factors in postoperative complications.[1,2,3,4,5]. The aim of the study is to determine the effect of changing the method of suturing on post-operative complications following the removal of impacted lower wisdom teeth, and to determine the best method of suturing technique associated with less complication. All the cases were performed by the same surgeon, all of the impacted teeth were surgically extracted under local anaesthesia obtained by inferior alveolar, lingual and long buccal nerve block injections using 3.6 ml of 2% xylocaine with 1:80 000 adrenaline. The surgical removal of the impacted teeth was performed following the standard procedure including modified flaps. Grade 3= Edema of alveolar mucosa buccally and /or lingually and involve the cheek (extraorally) below the lower border of the mandible.[18,19] Data for pain and swelling recorded for day one, three, seven post operatively. Analysis were performed using SPSS program version 19 windose A highly significant difference was considered at p < 0.01

II III

DISCUSSION

Birn H

Blum IR