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Background: Lower third molar surgery remains one of the most common surgical procedure in oral and maxillofacial surgery. It has its own risks, and post-operative complications, that influence the recovery period, and affect a patient’s quality of life. This study aims to determine which of the two secondary closure techniques assessed is superior in improving wound healing, and reducing post-operative complications, following lower third molar surgery. Material & Methods: We carried out a prospective, randomised, double-blind, split-mouth controlled trial on 37 patients, who had bilateral impacted third molars of similar surgical difficulty, were recruited, with 34 successfully completing the study. We compared partial closure using one suture to the suture-less technique. Surgical sites were divided into two groups, Group A: one suture, and Group B: suture-less. Each patient received both treatments at the same time. During the first post-operative week, all patients were asked to daily assess pain, facial swelling, and bleeding, using subjective self-assessment scales. Results: The results showed a statistically significant difference between the two techniques in the following outcomes: a) less post-operative pain in one suture technique at day five (p = 0.046), and six (p = 0.034), b) better socket healing at one week (p = 0.002), and one month (p = 0.014) in one suture technique, and c) better soft tissue healing at one week (p = 0.016) in one suture technique. Conclusion: The one-suture technique for lower third molar surgery is superior to the suture-less technique in reduction of post-operative pain at day five and day six, and improving wound healing at one week and at one month post-operatively. There is no difference between the two techniques in reduction of post-operative swelling.

A comparative study of the effect of suture and suture-less techniques on post-operative complications following lower third molar surgery