Tissue Adhesive or Suture for Wound Closure Following Surgical Removal of an Impacted Mandibular Third Molar: A Randomized Comparative Study
Nusrin Thoniyottupurayil, H T Arvind Rao, Joyce Sequeira
Cyanoacrylate adhesive, Impacted third molar, Mervilyte, Mucoperiosteal flap
Citation Information :
Thoniyottupurayil N, Rao HT, Sequeira J. Tissue Adhesive or Suture for Wound Closure Following Surgical Removal of an Impacted Mandibular Third Molar: A Randomized Comparative Study. World J Dent 2022; 13 (6):587-593.
Aim: To compare the efficacy of isoamyl 2-cyanoacrylat and 3–0 silk suture for the closure of wound after surgical removal of the impacted mandibular third molar.
Materials and methods: This research was carried out on fourteen patients of both sexes, with a range of 18–35 years of age. Patients were randomly assigned to one of two groups (study or control) each with a submerged mesioangular impacted mandibular third molar (Class II Position B of Pell and Gregory's classification). After the surgical extraction of an impacted tooth, the flaps were closed using isoamyl 2-cyanoacrylate (Mervilyte) tissue adhesive in the study group and using 3–0 silk sutures in the control group. Recorded the time taken for placement of silk suture or cyanoacrylate tissue adhesive for the closure of the surgical wound. Both patient groups were given similar medication and postoperative instruction. Patients were recalled on postoperative day 1, day 3, and day 7 for evaluating postoperative pain, bleeding, and wound healing.
Results: Fourteen subjects were enrolled in this study. In cyanoacrylate treated wounds, there was a considerable clinical and statistical improvement. The time it took to close a wound using isoamyl 2-cyanoacrylate was shorter (2.13 ± 0.61) whereas it was longer for the silk suture group (6.34 ± 1.86). Early hemostasis was achieved with isoamyl 2-cyanoacrylate. Postoperative discomfort and hemorrhage were reduced when compared to the silk suture group. In the isoamyl 2-cyanoacrylate group, wound healing was also improved.
Conclusion: The use of cyanoacrylate tissue adhesive is a good method for the closure of mucoperiosteal flaps that is capable of overcoming most of the complications associated with traditional silk sutures, as well as providing ease of manipulation, time savings, and safety.
Clinical significance: Cyanoacrylate tissue an adhesive is an alternative option for intraoral wound closure following surgical removal of impacted third molars because of its quick working time, ease of application, lower incidence of wound infection, and patient as well as surgeon comfort during the surgery.
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