Faculty of Dentistry Complutense University of Madrid Plaza Ramón y Cajal, s/n 28040, Madrid, Spain
Med Oral Patol Oral Cir Bucal. 2024 Jul 1;29(4):e458-e467. doi: 10.4317/medoral.26375.
Sutures have been the standard flap closure method of choice following mandibular third molar surgery but can lead to some complications. Tissue adhesives, including cyanoacrylate, have emerged as alternative flap closure method in this surgery to overcome such drawbacks. However, limited clinical trials can be found. Therefore, the aim of this clinical study was to compare two methods of flap closure in mandibular third molar surgery, cyanoacrylate and 4/0 silk sutures, by assessing post-operative outcome measures (pain, swelling, trismus, and healing) and patient-reported outcome measures (PROMs).
A randomized split-mouth clinical trial was designed, in which mandibular third molar (M3M) extractions were performed, where the control side flap was closed with 4/0 silk sutures and the test side flap with cyanoacrylate. Swelling, pain, trismus, healing, and PROMs were recorded post-operatively. These variables were analyzed by means of the nonparametric Mann-Whitney U test, using SPSS statistical software version 28.0.0 (IBM® SPSS®, Chicago, IL, USA). For all results, a 95% confidence interval was recorded (significance level p < 0.05, two-tailed).
A total of 17 patients were recruited and 34 mandibular third molar extractions were performed. No statistically significant differences were found in terms of swelling, pain, trismus, healing, and PROMs between both groups (p<0.05).
No statistically significant differences were found between flap closure with 4/0 silk sutures and cyanoacrylate, in terms of surgical post-operative outcomes and PROMs. However, further studies with larger sample sizes are required to be able to affirm it with greater certainty.
缝线一直是下颌第三磨牙手术后选择的标准皮瓣关闭方法，但会导致一些并发症。组织粘合剂，包括氰基丙烯酸酯，已成为这种手术中替代皮瓣关闭方法，以克服这些缺点。然而，目前可以找到的临床试验有限。因此，本临床研究的目的是通过评估术后结果测量（疼痛、肿胀、张口受限和愈合）和患者报告的结果测量（PROMs）来比较下颌第三磨牙手术中两种皮瓣关闭方法，氰基丙烯酸酯和 4/0 丝线，比较两种方法。
设计了一项随机分侧临床研究，其中进行了下颌第三磨牙（M3M）拔除术，其中对照组皮瓣用 4/0 丝线关闭，实验组皮瓣用氰基丙烯酸酯关闭。术后记录肿胀、疼痛、张口受限、愈合和 PROMs。使用 SPSS 统计软件版本 28.0.0（IBM® SPSS®，芝加哥，IL，USA），通过非参数 Mann-Whitney U 检验对这些变量进行分析。对于所有结果，记录了 95%的置信区间（显著性水平 p < 0.05，双侧）。
共招募了 17 名患者，进行了 34 例下颌第三磨牙拔除术。两组在肿胀、疼痛、张口受限、愈合和 PROMs 方面无统计学差异（p<0.05）。
在手术术后结果和 PROMs 方面，4/0 丝线和氰基丙烯酸酯皮瓣关闭方法之间无统计学差异。然而，需要进一步进行更大样本量的研究，以便更有把握地确认这一点。
