Damodar Neeliahgari Durga Akhila, Nandakumar Hanumanthaiah, Srinath Narashimha Murthy
Department of Oral and Maxillofacial Surgery, VIDS and Research Centre, Bangalore, India.
Gen Dent. 2013 May-Jun;61(3):e9-e13.
This study sought to evaluate postoperative recovery after mandibular third molar surgery, with and without the use of sutures. This study utilized 50 healthy subjects (19 females and 31 males, 18-40 years of age) with bilateral impacted third molars. Two impacted teeth were removed from each patient (60 min maximum operating time). For each patient, the surgical site on one side of the mouth was closed for primary healing by using nonresorbable sutures, while the surgical site on the other side of the mouth was left open for secondary healing. Postoperative recovery was assessed by determining pain (using a visual analog scale) and swelling (by measuring anatomical landmarks pre- and postoperatively on Days 2, 5, and 7) Any incidence of socket infection and hemorrhage were considered to be complications. Both statistical analysis and clinical observation showed that the surgical sites with nonresorbable sutures showed greater swelling and a higher intensity of pain than the surgical sites without sutures; however, there were no statistical or clinical differences in pain and swelling postsurgery at Day 7. The results suggest secondary closure (that is, without sutures) after third molar surgery will produce less postoperative discomfort than primary closure (with nonresorbable sutures).
本研究旨在评估下颌第三磨牙手术后使用缝线与不使用缝线情况下的术后恢复情况。本研究纳入了50名健康受试者(19名女性和31名男性,年龄在18至40岁之间),均双侧有阻生第三磨牙。从每位患者口中拔除两颗阻生牙(最长手术时间60分钟)。对于每位患者,一侧口腔的手术部位使用不可吸收缝线进行缝合以实现一期愈合,而另一侧口腔的手术部位则保持开放以实现二期愈合。通过测定疼痛(使用视觉模拟量表)和肿胀情况(在术后第2天、第5天和第7天测量术前和术后的解剖标志)来评估术后恢复情况。任何牙槽窝感染和出血的发生率都被视为并发症。统计分析和临床观察均表明,使用不可吸收缝线的手术部位比未使用缝线的手术部位肿胀更明显,疼痛强度更高;然而,术后第7天时,疼痛和肿胀在统计学和临床上均无差异。结果表明,下颌第三磨牙手术后二期缝合(即不使用缝线)比一期缝合(使用不可吸收缝线)产生的术后不适更少。