# Evaluation of the Effect of Polybutester and Polypropylene
## 1 Introduction  
The removal of an impacted lower third molar (ILTM) is one of the most common oral surgery procedures. Before deciding to remove affected teeth, the necessity of the procedure and possible complications arising from the procedure must be evaluated. Patients are informed about the possible risks before the procedure. Asymptomatic teeth that are located far away from the adjacent tooth, have complete root formation, are completely surrounded by bone and are deeply located are more suitable for follow-up rather than extraction. When the decision is made to leave the tooth in place, the patient should be followed up regularly for a possible pathologic condition. The patient should also be informed about complications that may occur with advancing age [1]. It usually takes 7-10 days for the patient to recover after the extraction of ILTMs. During this period, postoperative complications resulting from inflammatory tissue reactions negatively affect the daily routines of patients [2, 3]. There may be postoperative complications such as pain, swelling, trismus, alveolitis, bleeding, nerve damage and damage to the temporomandibular joint [4]. Various methods are used to treat complications, such as drugs, cold or hot compresses, different surgical approaches or low-dose laser therapy [5, 6, 7]. Sutures are materials used to close wound surfaces and/or compress blood vessels to stop bleeding. Sutures are still the most commonly used method of stitching surgical incision lines together. In recent years, efforts have been made to reach the ideal suture material in parallel with technological developments and the properties of suture materials have been improved [8]. The ideal suture material should create sufficient tension to close the wound site without creating a dead space, be loose enough not to cause ischemiaor necrosis in the tissue, provide hemostasis and allow for proper flap positioning, have appropriate tensile strength against rupture, have good knot security to prevent untying, be flexible and workable, have low tissue reactivity and be resistant to bacterial infection. It should also reduce postoperative pain, prevent bone exposure due to delayed healing and prevent unfavorable resorption [9]. The choice of material for sutures usually depends on the type of wound and the surgeon's preference. Today, there are many suture materials with different chemical, physical, mechanical and biological properties [10]. The polybutester (PE) suture material is a copolymer made from polyglycol terephthalate and polybutylene terephthalate. It is a synthetic monofilament suture material that is not absorbable. Compared to other monofilaments like polypropylene and nylon, PE is stronger [11]. Sutures have a weak suture memory and do not retain the shape of the package. This makes it easier to work with and increases knotting security. Compared to other synthetic sutures, PE sutures adapt better to tension. Most suture materials show limited elasticity in the case of increased tension. After a certain load, they lose their elasticity and undergo a dimensional change called creep. This value is quite low in PE sutures. PE sutures exhibit a high level of elasticity under low load. After this, it will elongate until it breaks at a load similar to other suture materials. Compared to other non-resorbable monofilament sutures, this controlled low-strain elongation offers significant clinical advantages. The PE suture is designed to conform to increasing wound oedema and return to its original shape as the oedema subsides. Its ability to adapt to the changing configuration of the wound also reduces the risk of hypertrophic scarring. It gives better cosmetic results [8; 11]. Polypropylene (PP) sutures are produced by forming isotactic stereoisomers of a linear hydrocarbon crystalline polymer into sterile monofilaments. It is a non-absorbable synthetic monofilament suture made from the polymer PP [12]. It is one the most widely used monofilament sutures [13].