Comparison of Effects of the Interrupted and Vertical Mattress Sutures on Pain, Swelling, and Probing Depth Following Extraction of Impacted Mandibular Third Molars: A Split-Mouth Randomized Clinical Trial

Complications following dental extraction include the development of a dry socket, pain, swelling, infection, trismus, pocket formation in the adjacent teeth, or absence of healing. The material and technique used for suturing vastly influence the success or failure of a suture. The present study aimed to evaluate and compare the postoperative pain, swelling, and distal probing depth of the mandibular second molar following the placement of interrupted suture (IS) and vertical mattress suture (VMS) after extraction of impacted third molars.

The present split-mouth randomized controlled trial was conducted on 100 patients requiring surgical extraction of bilateral impacted mandibular third molars. The extraction socket was closed by IS on one side and VMS on the other. The pain and swelling scores were obtained by the visual analog scale during the first-week post-extraction. The probing depth distal to the mandibular second molars was taken at 2-month intervals until 6 months post-extraction.

Inter-group comparison revealed significantly lower values (P < 0.001) of pain levels and swelling scores for the IS group during the first four postoperative days. There was a mean increase in the pocket depth by 0.16 + 0.77 in the wounds closed by IF, while a reduction in the pocket depth with a 0.61 + 0.74 mean gain in attachment levels was noted in the VMS group. A statistically significant difference (P < 0.05) in the pocket depth of the two groups was noted at every 2-month interval with greater pocket depth in patients of the IF group.

While IS can be considered a simple-to-execute suturing technique with less operative pain initially, the VMS was found to be better in the long run in its ability to reduce the detrimental effects on the periodontium of the adjacent tooth.