Comparing Different Suturing Techniques on the Post-operative Morbidity After Removal of Impacted Mandibular Third Molar

Study Overview
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Brief Summary
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This study compares the effect of two types of suturing techniques in the postoperative swelling and mouth opening after surgical removal of impacted mandibular third molar. total wound closure will be performed in one group of participants while partial closure will be performed in the other group.

Detailed Description
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Third molar surgeries are mostly associated with pain, swelling and limited mouth opening, referred to as post-operative morbidity. Wound closure technique is an operative factor which is associated with reduced post-operative morbidity. In the total wound closure, the mucoperiosteum is hermetically sealed whereas in the partial wound closure, a window or opening is left to allow for secondary healing. This study therefore compares the effect of partial and total wound closure techniques after surgical extraction of impacted mandibular third molar teeth in reducing the swelling and limited mouth opening.

Official Title
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Comparing the Effect of Different Suture Techniques on the Post Operative Morbidity After Surgical Removal of Impacted Mandibular Third Molar- A Randomized Clinical Study

Conditions
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Swelling, Trismus

Intervention / Treatment
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* Procedure: partial wound closure
* Procedure: total wound closure


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: all patients undergoing surgical removal of mesioangular impacted mandibular third molar. Healthy patients (ASA I) or patients with mild systemic disease with no functional limitations (ASA II). patients who are not allergic to the drugs and local anesthetic agent used in the surgical protocol. Exclusion Criteria: Patients having systemic conditions that might have an effect on the bone growth or periodontal healing. patients who are on antibiotics premedication or any drugs that might affect wound healing.

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Partial wound closure<br>3 sutures distal to second molar and leaving the vertical releasing incision open without any sutures. | Procedure: partial wound closure<br>* 3 sutures distal to second molar and leaving the vertical releasing incision open without any sutures.<br>|
| Active Comparator: Total wound closure<br>5 interrupted sutures with 2 sutures closing the vertical releasing incision and 3 sutures distal to second molar leading to a complete hermetic closure of the wound. | Procedure: total wound closure<br>* 5 interrupted sutures with 2 sutures closing the vertical releasing incision and 3 sutures distal to second molar leading to a complete hermetic closure of the wound.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in the Measurement of mouth opening | mouth opening is measure by measuring the maximum interincisal distance from the incisal edge of maxillary right central incisor to the incisal edge of the lower right central incisor using a vernier calliper in mm. | baseline( preoperative) and 3rd and 7th day postoperatively. | 
| postoperative swelling | three line measurements were performed in cm using a measuring tape and mean was taken | baseline ( preoperative) and 3rd and 7th day postoperatively. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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impacted third molar, suturing, post-operative morbidity