Background <p>The objective of this study is to evaluate and compare the efficacy of knotless barbed suture and conventional suture for wound healing in intra-oral incisions of patients undergoing transalveolar extractions.</p> Methodology <p>A randomized controlled trial was conducted with well-constructed inclusion and exclusion criteria. Patients were selected per inclusion criteria and allotted into the control and study groups based on a computer-generated randomization sequence. The materials were 3–0 knotless barbed PDS sutures and conventional 3–0 polyglactin (910 vicryl) suture materials. Parameters assessed include time taken for incision closure intraoperatively. Facial swelling, mouth-opening, intensity of pain and wound assessment using “Landry wound healing index” on postoperative 3rd and 7th days. Statistical analysis for intra and inter-group comparisons was done using paired and unpaired t-tests. A p-value less than 0.05 was set as statistical significance.</p> Results <p>Fifty-two participants were equally divided into two groups: the control and study group had 26 participants, each undergoing transalveolar extraction. The mean (SD) time taken for wound closure was 4.01 (0.64) minutes in the study group (<i>p</i> = 0.001), which was statically significant compared to the control group 6.83 (0.76) minutes. The differences in wound healing, the intensity of pain, facial swelling, and mouth opening were all statistically significant (<i>p</i> = 0.001) on the 3rd and 7th post-operative days in the study group compared to the control group.</p> Conclusion <p>Knotless barbed sutures have merits over conventional sutures in terms of superior wound healing, reduced incision closure time and better post-operative sequelae. Hence, Knotless barbed suture is an effective alternative to traditional suture for intra-oral incision closure.</p> Trial registration <p>CTRI registration no CTRI/2023/04/052127.</p>