Publication:

Effectiveness of knotless barbed suture compared with vicryl suture in impacted third molar surgery: a randomized split-mouth study

Background Wound closure following surgical extraction of impacted third molars directly influences postoperative recovery. Conventional vicryl sutures require knot placement, which prolongs closure time, increases infection risk, and may cause uneven tissue tension. Knotless barbed sutures eliminate these drawbacks through self-anchoring barbs. Objectives were to compare knotless barbed sutures with conventional vicryl sutures for soft tissue wound healing, wound closure time, postoperative pain, and trismus following bilateral impacted mandibular third molar surgery.

Methods A randomized split-mouth design was employed in 15 patients (aged 18-50 years) undergoing bilateral mandibular third molar extraction. One side received 3-0 knotless barbed sutures (study group); the contralateral side received 3-0 polyglactin 910 (Vicryl) sutures (control group). Parameters assessed on postoperative days 3 and 7 included wound healing (Landry-Turnbull index), suturing time (stopwatch), pain VAS (Visual analog scale), and trismus (maximal interincisal distance via Vernier caliper). Data were analyzed using SPSS Version 26.

Results Barbed sutures demonstrated significantly shorter closure time (2.6±0.35 min vs. 4.06±0.38 min; p<0.001), superior wound healing scores on day 7 (4.87±0.34 vs. 3.53±0.50; p<0.001), and lower pain scores on day 7 (0.87±0.88 vs. 2.0±0.89; p=0.002). No statistically significant difference in trismus was observed between groups at any time point.

Conclusions Knotless barbed sutures are a clinically superior alternative to vicryl sutures for closure after impacted third molar surgery, offering faster wound closure, improved healing, and reduced postoperative pain.