Department of Oral and Maxillofacial Surgery, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Türkiye.
Department of Oral and Maxillofacial Surgery, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Türkiye -
Minerva Dent Oral Sci. 2023 Aug;72(4):161-167. doi: 10.23736/S2724-6329.23.04764-2. Epub 2023 Mar 23.
Several types of suture materials are available for oral surgery. However, the most used non-resorbable suture in oral surgery is 3/0 silk. The aim of the present study was to compare the effectiveness of knotless/barbed sutures with silk sutures during the postoperative period after the third molar surgery in terms of clinical and microbiological parameters.
The study comprised 38 patients who underwent surgical extraction of a mandibular impacted third molar. The patients were divided into two groups. The mucoperiosteal flap was closed using 3/0 knotless/barbed sutures for the test group and 3/0 silk sutures for the control group. The duration of suturing was recorded during surgery. Pain level, postoperative edema, and trismus were measured at 3 and 7 days after surgery. The status of plaque formation on the sutures was scored using the Plaque Index at 3 and 7 days after the surgery. At 7 days, the suture materials were removed and submitted to the laboratory for microbiological analysis. The level of pain during suture removal was also recorded by a Visual Analog Scale.
The duration of suturing in the barbed sutures group was found significantly lower than in silk sutures (P<0.05). There was no significant difference between the suture types in terms of trismus and edema at 3 and 7 days after surgery (P>0.05). On the third day after surgery and during suture, removal pain scores were statistically significantly lower in the barbed suture group than in the silk suture group (P<0.05). The Plaque Index values of the barbed sutures were statistically significantly lower than that of the silk sutures at 3 and 7 days after surgery (P<0.05). Aerobic, anaerobic, and aerobic/anaerobic mean colony forming units (CFUs) were statistically significantly lower in the barbed suture group than in the silk suture group (P<0.05).
Barbed sutures increase the ease of operation and patient comfort with less postoperative pain than silk sutures. Additionally, less plaque accumulation and lower bacterial colonization were found on the barbed/knotless sutures than on the silk sutures.
口腔手术中可用的缝线种类很多，但口腔手术中最常使用的非可吸收缝线是 3/0 丝线。本研究旨在比较在第三磨牙手术后的围手术期，使用无结/倒刺缝线与丝线缝线在临床和微生物学参数方面的效果。
本研究纳入了 38 例行下颌阻生第三磨牙外科拔除术的患者。将患者分为两组，实验组使用 3/0 无结/倒刺缝线、对照组使用 3/0 丝线关闭黏膜骨膜瓣。记录手术中的缝合时间。术后 3 天和 7 天测量疼痛程度、术后肿胀和张口受限。术后 3 天和 7 天使用菌斑指数评估缝线处菌斑形成情况。术后 7 天拆除缝线并送至实验室进行微生物分析。拆除缝线时的疼痛程度也通过视觉模拟评分进行记录。
倒刺缝线组的缝合时间明显短于丝线组（P<0.05）。两组在术后 3 天和 7 天的张口受限和肿胀方面无显著差异（P>0.05）。术后第 3 天，缝线时以及拆除缝线时，倒刺缝线组的疼痛评分均显著低于丝线组（P<0.05）。术后 3 天和 7 天，倒刺缝线的菌斑指数显著低于丝线缝线（P<0.05）。与丝线缝线组相比，倒刺缝线组的需氧菌、厌氧菌和需氧/厌氧菌的平均菌落形成单位（CFU）均显著降低（P<0.05）。
与丝线缝线相比，倒刺缝线可增加操作的便利性并减轻术后疼痛，从而提高患者舒适度。此外，倒刺/无结缝线处的菌斑堆积和细菌定植较少。
