Comparative study of the effects of Suture-less and Multiple Sutures Techniques on Complications following Third Molar Surgery in a secondary health facility in Benin City, Nigeria

Abstract

Objective: To compare the effects of suture-less and multiple sutures techniques on complications following third molar surgery.

Methods: The study was a prospective randomized clinical study involving 112 patients (44 males and 68 females). The patients were randomly divided into two equal groups (suture-less n = 56; multiple suture n = 56). In the experimental group (suture-less, group1), the flaps were replaced without suturing. The control group (multiple sutures, group 2) was selected using the same criteria and treated under the same surgical protocol, except that the flaps were opposed using multiple sutures. Trismus, swelling and pain were evaluated at days 1, 2, 3, 5 and 7 postoperatively in both groups. Independent t-test was used to compare post-operative outcomes (trismus, swelling and pain) of both techniques. All statistical analyses were set at 5% level of significance.

Results: The mean age of the participants was 34.2 + 12.3 years in group1 and 30.5 ± 7.6 years in group 2. The ratio of males to females was 2:3. Over 90% of the participants live in Benin City. Reduction in mouth opening (trismus) was consistently less among the patients that received suture-less technique (group 1) than among those that received multiple suture technique (group 2) across all postoperative evaluation days (1,2,3,5 & 7). This difference was however only statistically significant (p<0.05) in postoperative day 1. At evaluation on the first, second and third postoperative days, facial swelling, when measured from tragus to pogonium (TP) and when measured from tragus to commissure (TC), were found to be significantly less (p<0.05) in the group in which no suturing was done (group 1) compared to the other group that received multiple sutures. Pain reduction was found to be significantly more (p<0.05) in the group that received suture-less technique (group 1) compared to the group that received multiple sutures technique (group 2) on postoperative day 1. There was no significant difference between both groups at postoperative days 2, 3, 5 and 7.

Conclusion: This study has shown that suture-less technique can be used in third molar surgery, including those performed via standard incisions. The suture-less technique is a simple and viable option for minimizing the postoperative morbidity associated with inflammatory sequelae after third molar surgery.