Comparison of Pain, Facial Swelling and Mouth Opening of Single Versus Multiple Suture Technique After Third Molar Extraction
Comparison of Single Versus Multiple Suture Technique After Third Molar Extraction
DOI:
https://doi.org/10.54393/pjhs.v5i08.1727Keywords:
Extraction, Inflammatory Complications, Suture, Third Molar, Pell-Gregory Classification, Visual Analog ScaleAbstract
Extraction of the third molar is a common technique. Pain, swelling and trismus are common signs of local inflammation during the postoperative phase. Moreover, opinions are divided when it comes to the mucosal closure phase of impacted mandibular third molar Objective: To compare the pain, facial swelling and mouth opening of single versus multiple suture techniques after third molar extraction. Methods: This quasi-experimental study included 54 patients aged 18-35 requiring mesioangular mandibular third molar extraction. Participants were non-randomly assigned to Group A (single suture) or Group B (multiple suture). Exclusions were based on suture allergies, chronic conditions, pregnancy, lactation, or acute infections. Impacted molars were classified using the Pell-Gregory system, and radiographs assessed impaction. Participants were instructed to return on the 1st, 3rd, and 7th postoperative days for assessment of Pain, swelling, and mouth opening, and comparisons between the two groups were made using the Student's t-test. Results: Patients in groups A and B had mean and standard deviation pain levels of 6.9 ± 0.9 and 6.4 ± 0.9 post-operatively on Day 1 and 2.0 ± 2.1 and 2.5 ± 2.7 on Day 7. Post-operative facial swelling measured 15.4 ± 2.4 and 17.0 ± 3.4 mm on Day 1, 14.8 ± 2.4 and 4 ± 2.7 mm on Day 7 in groups A and B. Mean and standard deviation of mouth opening in groups A and B were 26.5 ± 3.6 and 23.7 ± 2.8 mm post-operatively at Day 1, 29.6 ± 3.6 and 27.2 ± 3.0 mm at Day 7. Conclusions: It was concluded that based on post-operative pain, swelling, mouth opening, and trismus following third molar extraction, single suture approach was somewhat better than multiple suture.
References
Rajper WA, Channar KA, Larik MD, Majeedano SA, Soomro AA, Hussain A. Comparison of Postoperative Complications after Impacted Mandibular Third Molar Extraction with Conventional Suturing Versus Tube Drainage. The Professional Medical Journal. 2020 Jul; 27(07): 1408-13. doi: 10.29309/TPMJ/2020.27.07.4011. DOI: https://doi.org/10.29309/TPMJ/2020.27.07.4011
Ali R, Shaikh T, Memon M, Shams S. Efficacy of Intra-Masseteric and Submucosal Dexamethasone Injection in Surgical Extraction of Impacted Lower Third Molar. The Professional Medical Journal. 2019 Jul; 26(07): 1141-6. doi: 10.29309/TPMJ/2019.26.07.3786. DOI: https://doi.org/10.29309/TPMJ/2019.26.07.3786
Osunde OD, Saheeb BD, Adebola RA. Comparative Study of Effect of Single and Multiple Suture Techniques on Inflammatory Complications after Third Molar Surgery. Journal of Oral and Maxillofacial Surgery. 2011 Apr; 69(4): 971-6. doi: 10.1016/j.joms.2010.05.009. DOI: https://doi.org/10.1016/j.joms.2010.05.009
Ma S, Li X, Zhang A, Liu S, Zhao H, Zhao H. Efficacy of Secondary Closure Technique after Extraction of Third Molars: A Meta-Analysis. British Journal of Oral and Maxillofacial Surgery. 2019 Dec; 57(10): 977-84. doi: 10.1016/j.bjoms.2019.08.028. DOI: https://doi.org/10.1016/j.bjoms.2019.08.028
Syed KB, AlQahtani FH, Mohammad AH, Abdullah IM, Qahtani HS, Hameed MS. Assessment of Pain, Swelling and Trismus Following Impacted Third Molar Surgery Using Injection Dexamethasone Submucosally: A Prospective, Randomized, Crossover Clinical Study. Journal of International Oral Health. 2017 May; 9(3) :116-21. doi: 10.4103/jioh.jioh_65_17. DOI: https://doi.org/10.4103/jioh.jioh_65_17
Balamurugan R and Zachariah T. Comparison of Primary and Secondary Closure with A Buccal Mucosal-Advancement Flap on Postoperative Course After Mandibular Impacted Third Molar Surgery. Oral and Maxillofacial Surgery. 2020 Mar; 24: 37-43. doi: 10.1007/s10006-019-00814-w. DOI: https://doi.org/10.1007/s10006-019-00814-w
Rodrigues ÉD, Martins-de-Barros AV, Loureiro AM, Carvalho MD, Vasconcelos B. Comparison of Two Suture Techniques on the Inflammatory Signs After Third Molars Extraction–A Randomized Clinical trial. Plos One. 2023 Jun; 18(6): 1-12. doi: 10.1371/journal.pone.0286413. DOI: https://doi.org/10.1371/journal.pone.0286413
Osunde OD, Adebola RA, Saheeb BD. A Comparative Study of the Effect of Suture-less and Multiple Suture Techniques on Inflammatory Complications Following Third Molar Surgery. International Journal of Oral and Maxillofacial Surgery. 2012 Oct; 41(10): 1275-9. doi: 10.1016/j.ijom.2012.04.009. DOI: https://doi.org/10.1016/j.ijom.2012.04.009
Kakadia U, Patel K, Kumar KA, Khare G, Patel N. A Comparative Study of Primary Versus Secondary Closure after Removal of Lower Third Molar. International Journal of Clinical Dental Science. 2013 May; 4(1): 1-7.
Waite PD and Cherala S. Surgical Outcomes for Suture-less Surgery in 366 Impacted Third Molar Patients. Journal of Oral and Maxillofacial Surgery. 2006 Apr; 64(4): 669-73. doi: 10.1016/j.joms.2005.12.014. DOI: https://doi.org/10.1016/j.joms.2005.12.014
Koyuncu BÖ, Zeytinoğlu M, Tetik A, Gomel MM. Effect of Tube Drainage Compared with Conventional Suturing on Postoperative Discomfort After Extraction of Impacted Mandibular Third Molars. British Journal of Oral and Maxillofacial Surgery. 2015 Jan; 53(1): 63-7. doi: 10.1016/j.bjoms.2014.09.021. DOI: https://doi.org/10.1016/j.bjoms.2014.09.021
Alkadi S and Stassen L. Effect of One-Suture and Sutureless Techniques on Postoperative Healing After Third Molar Surgery. Journal of Oral and Maxillofacial Surgery. 2019 Apr; 77(4): 703.e1-703.e16. doi: 10.1016/j.joms.2018.12.001. DOI: https://doi.org/10.1016/j.joms.2018.12.001
Santos KK, Lages FS, Maciel CA, Glória JC, Douglas-de-Oliveira DW. Prevalence of Mandibular Third Molars According to the Pell & Gregory and Winter Classifications. Journal of Maxillofacial and Oral Surgery. 2022 Jun; 21: 1-7.
Lau AA, De Silva RK, Thomson M, De Silva H, Tong D. Third Molar Surgery Outcomes: A Randomized Clinical Trial Comparing Submucosal and Intravenous Dexamethasone. Journal of Oral and Maxillofacial Surgery. 2021 Feb; 79(2): 295-304. doi: 10.1016/j.joms.2020.09.020. DOI: https://doi.org/10.1016/j.joms.2020.09.020
Azab M, Ibrahim S, Li A, Khosravirad A, Carrasco-Labra A, Zeng L et al. Efficacy of Secondary Vs Primary Closure Techniques for the Prevention of Postoperative Complications After Impacted Mandibular Third Molar Extractions: A Systematic Review Update and Meta-Analysis. The Journal of the American Dental Association. 2022 Oct; 153(10): 943-56. doi: 10.1016/j.adaj.2022.04.007. DOI: https://doi.org/10.1016/j.adaj.2022.04.007
Pachipulusu PK. Comparative Study of Primary and Secondary Closure of the Surgical Wound After Removal of Impacted Mandibular Third Molars. Oral and Maxillofacial Surgery. 2018 Sep; 22: 261-66. doi: 10.1007/s10006-018-0696-8. DOI: https://doi.org/10.1007/s10006-018-0696-8
Shuja E, Orakzai GS, Khan MN, Siddiqui MO. Comparing Pain and Trismus in “Primary” and “Secondary” Closure of Surgical Wound After Removal of Impacted Mandibular Third Molar. Journal of Rawalpindi Medical College. 2020 Mar; 24(1): 8-11. doi: 10.37939/jrmc/vol24.iss1.3. DOI: https://doi.org/10.37939/jrmc/vol24.iss1.3
Maria A, Malik M, Virang P. Comparison of Primary and Secondary Closure of the Surgical Wound After Removal of Impacted Mandibular Third Molars. Journal of Maxillofacial and Oral Surgery. 2012 Sep; 11: 276-283. doi: 10.1007/s12663-011-0287-9. DOI: https://doi.org/10.1007/s12663-011-0287-9
Mahat AK, Yadav R, Yadav AK, Acharya P, Dongol A, Sagtani A et al. A Comparative Study of the Effect of Sutureless Versus Multiple Sutures Technique on Complications Following Third Molar Surgery in Nepalese Subpopulation. International Journal of Dentistry. 2020 Feb; 2020(1): 2-6. doi: 10.1155/2020/9314762. DOI: https://doi.org/10.1155/2020/9314762
Zhang Y, Zhuang P, Jia BO, Xu J, Cui Q, Nie L et al. Persistent Trismus Following Mandibular Third Molar Extraction and its Management: A Case Report and Literature Review. World Academy of Sciences Journal. 2021 Jan; 3(1): 1. doi: 10.3892/wasj.2020.73. DOI: https://doi.org/10.3892/wasj.2020.73
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments