Mehdizadeh Mohammad, Karkoubzadeh Abolfazl
Dept. of Oral and Maxillofacial Surgery, Faculty of Dentistry, Qom University of Medical Sciences and Health Services, Qom, Iran.
Student Research Committee, Faculty of Dentistry, Qom University of Medical Sciences and Health Services, Qom, Iran.
J Dent (Shiraz). 2025 Sep 1;26(3):226-232. doi: 10.30476/dentjods.2024.102038.2332. eCollection 2025 Sep.
Surgical removal of impacted mandibular wisdom teeth may be associated with postoperative complications such as infection, bleeding, edema, pain, ecchymosis and trismus. It seems that the number of sutures and the duration of surgery for impacted wisdom teeth are among the factors affecting the aforementioned complications.
This study aimed to compare single-suture versus multiple-suture techniques regarding postoperative pain, trismus, edema, ecchymosis, and operating time in surgical removal of impacted mandibular wisdom teeth by envelope flap surgery.
This double-blind split-mouth randomized controlled clinical trial was conducted on 30 patients requiring bilateral surgical extraction of impacted wisdom teeth with the same level of impaction through an envelope flap. In each patient, wisdom teeth of one randomly selected quadrant was extracted through an envelope flap and single-suture technique (experimental group) while the wisdom teeth of the other quadrant was extracted through an envelope flap by multiple-suture technique (control group). The two groups were compared regarding operative time, and also pain score, trismus (mouth opening), edema, and ecchymosis at 1, 3 and 7 days postoperatively using paired t-test (alpha= 0.05).
The two groups had no significant difference in pain score, edema, and ecchymosis at any time point (> 0.05). The operative time (= 0.005) was significantly longer, and mouth opening at 1, 3 and 7 days postoperatively (< 0.05) was significantly smaller in the multiple-suture group.
In the present study, postoperative trismus was significantly lower in the single-suture group than multiple-suture group, and the multiple-suture group had significantly longer operative time. Thus, single-suture technique appears to be superior to multiple-suture technique, and may be suggested for surgical removal of impacted mandibular wisdom teeth.
拔除下颌阻生智齿的手术可能会引发术后并发症，如感染、出血、水肿、疼痛、瘀斑和牙关紧闭。似乎缝合线的数量以及阻生智齿的手术时长是影响上述并发症的因素。
本研究旨在通过信封瓣手术比较单缝合法与多缝合法在拔除下颌阻生智齿术后疼痛、牙关紧闭、水肿、瘀斑及手术时间方面的差异。
本双盲、口内双侧随机对照临床试验选取了30例需要通过信封瓣手术双侧拔除阻生智齿且阻生程度相同的患者。在每位患者中，随机选择一个象限的智齿通过信封瓣和单缝合法拔除（试验组），而另一个象限的智齿通过信封瓣多缝合法拔除（对照组）。使用配对t检验（α = 0.05）比较两组的手术时间，以及术后1天、3天和7天的疼痛评分、牙关紧闭（开口度）、水肿和瘀斑情况。
两组在任何时间点的疼痛评分、水肿和瘀斑方面均无显著差异（> 0.05）。多缝合法组的手术时间（= 0.005）显著更长，术后1天、3天和7天的开口度（< 0.05）显著更小。
在本研究中，单缝合法组术后牙关紧闭情况明显低于多缝合法组，且多缝合法组手术时间明显更长。因此，单缝合法似乎优于多缝合法，可推荐用于下颌阻生智齿的手术拔除。
