Comparative study of effect of single and multiple suture techniques on inflammatory complications after third molar surgery.
OBJECTIVE
Pain, swelling, and trismus are the most common complications associated with third molar surgery. Several methods of alleviation of these complications have been described. The effect of single and multiple suture techniques on these complications was compared in the present study.


METHODS
All consecutive patients 18 years of age or older who had been referred for surgical extraction of their impacted teeth between January and December 2007 at the maxillofacial unit of the Aminu Kano Teaching Hospital were recruited and randomized into 2 groups. All selected participants underwent surgical extraction of their impacted teeth by the same surgeon under local anesthesia. The flaps in 1 group were closed by multiple sutures and those in the second group were closed by a single suture. Pain, swelling, and trismus were evaluated at postoperative days 1, 2, 3, 5, and 7. Descriptive and comparative statistical analyses were performed, and the results are presented. Significance was set at P < .05.


RESULTS
A total of 50 subjects participated in the present study. Both groups were comparable in terms of the age distribution (multiple suture group, 26.0 ± 4.73 years; single suture group, 25.8 ± 4.28 years, P = .755), difficulty index (multiple suture group, 5.0 ± 1.68; single suture group, 4.9 ± 4.79; P = .935), duration of surgery (multiple suture group, 29. 7 ± 6.11 minutes; single suture group, 30.0 ± 6.04 minutes; P = .835), and baseline parameters such as facial width (multiple suture group, 10.0 ± 1.32 cm; single suture group, 9.8 ± 0.37 cm; P = .115), mouth opening (multiple suture group, 4.5 ± 1.32 cm, single suture group, 4.8 ± 0.26 cm; P = .165), and preoperative pain, which was 0 in both groups. Other comparable variables included impaction type (P = .210) and indication for surgery (P = .278). A statistically significant difference was found in the level of pain at postoperative days 1, 2, and 3 (P < .05). A similar significant difference was found in swelling and trismus (P < .05). At days 5 and 7, no significant differences were found between the 2 groups for all parameters of pain, swelling, and trismus (P > .05).


CONCLUSIONS
Our study had a comparable distribution of age, gender, and operative variables, such as the pattern of impaction, preoperative difficulty index, and operative time between patients undergoing the 2 methods of closure. With that, our results have shown that the single suture closure technique was better than the multiple suture technique with regard to postoperative pain, swelling, and trismus.
Osunde
Otasowie Daniel
OD
Department of Dental and Maxillofacial Surgery, Aminu Kano Teaching Hospital, Kano, Nigeria. otdany@yahoo.co.uk
Saheeb
Birch D
BD
Adebola
Rafel A
RA
D000293:Adolescent; D000328:Adult; D000556:Ambulatory Surgical Procedures; D000779:Anesthetics, Local / Q000008:administration & dosage; D002508:Cephalometry; D004311:Double-Blind Method; D004487:Edema / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D009407:Nerve Block; D010149:Postoperative Pain / Q000209:etiology*; D011183:Postoperative Complications; D011446:Prospective Studies; D013524:Surgical Flaps; D013536:Suture Techniques / Q000009:adverse effects; D013997:Time Factors; D014081:Tooth Extraction / Q000009:adverse effects; D014313:Trismus / Q000209:etiology*; D055815:Young Adult
D000779:Anesthetics, Local; D008012:Lidocaine