Comparison of Two Different Suture Knot Techniques on Post-Operative Trismus and Swelling After Impacted Third Molar Surgery (Impacted molar)

COMPARISON OF TWO DIFFERENT SUTURE KNOT TECHNIQUES ON POST-OPERATIVE TRISMUS AND SWELLING AFTER IMPACTED THIRD MOLAR SURGERY

To compare the two different suture knot techniques, locked and unlocked, in terms of mean on postoperative trismus and swelling after impacted mandibular third molar surgery.

Study Overview

• Status: Not yet recruiting
• Conditions: Trismus; Swelling
• Intervention / Treatment: Procedure: locking and non locking suture techniques; Procedure: non locking suture technique

Detailed Description

The rationale behind conducting a comparative analysis of two different suture knot techniques on postoperative trismus and swelling following impacted third molar surgery stems from the imperative need to optimize patient outcomes and improve surgical practices. Impacted third molar surgery, while a routine procedure in oral and maxillofacial surgery, often presents challenges in managing postoperative complications, particularly trismus and swelling, which can significantly impact patients' comfort, recovery, and overall satisfaction.

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Pakistan
    • Rawalpindi, Pakistan, Pakistan, 46200
      • Watim Medical and Dental College

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• • Healthy individuals

  • Gender: male and female
  • Age: 18-45 years
  • Mandibular third molar impaction all positions
  • Mandibular third molar impaction all classes

Exclusion Criteria:

• • Patients with ASA status III and above

  • Patients requiring multiple extractions in same appointment
  • Patients allergic to Lignocaine
  • Patients in whom adrenaline is contraindicated
  • Medically compromised individual such as those with poorly controlled diabetes, hypertension and pregnancy, etc.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: locking suture; effect of locking suture on trismus and swelling	Procedure: locking and non locking suture techniques; The participating patients will be randomly assigned into two groups, i.e. receiving locked (L) or unlocked (UL) sutures, using a lottery method. Equal patients will be assigned in both groups. In group L (Locked suturing), the flap will be repositioned and sutured with the locked technique (straight-reverse-straight) hermetically using 3-0 black silk. In group UL (Unlocked suturing), the flap will be repositioned and sutured with the unlocked technique (three straight knots) loosely using 3-0 black silk. Demographic details (including name, age, gender, contact) will be obtained and recorded on specific data collection forms. On the day of surgery before the surgery commences, measurements will be taken for trismus and swelling which will be entered on the data collection form. Trismus will be evaluated by measuring the distance between the mesio-incisal corners of the upper and lower right central incisors at maximum mouth opening in mm, using Castroviejo instrument. The facial swel; Procedure: non locking suture technique; The participating patients will be randomly assigned into two groups, i.e. receiving locked (L) or unlocked (UL) sutures, using a lottery method. Equal patients will be assigned in both groups. In group L (Locked suturing), the flap will be repositioned and sutured with the locked technique (straight-reverse-straight) hermetically using 3-0 black silk. In group UL (Unlocked suturing), the flap will be repositioned and sutured with the unlocked technique (three straight knots) loosely using 3-0 black silk. Demographic details (including name, age, gender, contact) will be obtained and recorded on specific data collection forms. On the day of surgery before the surgery commences, measurements will be taken for trismus and swelling which will be entered on the data collection form. Trismus will be evaluated by measuring the distance between the mesio-incisal corners of the upper and lower right central incisors at maximum mouth opening in mm, using Castroviejo instrument.
Experimental: non locking suture; effect of non locking suture on trismus and swelling	Procedure: locking and non locking suture techniques; The participating patients will be randomly assigned into two groups, i.e. receiving locked (L) or unlocked (UL) sutures, using a lottery method. Equal patients will be assigned in both groups. In group L (Locked suturing), the flap will be repositioned and sutured with the locked technique (straight-reverse-straight) hermetically using 3-0 black silk. In group UL (Unlocked suturing), the flap will be repositioned and sutured with the unlocked technique (three straight knots) loosely using 3-0 black silk. Demographic details (including name, age, gender, contact) will be obtained and recorded on specific data collection forms. On the day of surgery before the surgery commences, measurements will be taken for trismus and swelling which will be entered on the data collection form. Trismus will be evaluated by measuring the distance between the mesio-incisal corners of the upper and lower right central incisors at maximum mouth opening in mm, using Castroviejo instrument. The facial swel; Procedure: non locking suture technique; The participating patients will be randomly assigned into two groups, i.e. receiving locked (L) or unlocked (UL) sutures, using a lottery method. Equal patients will be assigned in both groups. In group L (Locked suturing), the flap will be repositioned and sutured with the locked technique (straight-reverse-straight) hermetically using 3-0 black silk. In group UL (Unlocked suturing), the flap will be repositioned and sutured with the unlocked technique (three straight knots) loosely using 3-0 black silk. Demographic details (including name, age, gender, contact) will be obtained and recorded on specific data collection forms. On the day of surgery before the surgery commences, measurements will be taken for trismus and swelling which will be entered on the data collection form. Trismus will be evaluated by measuring the distance between the mesio-incisal corners of the upper and lower right central incisors at maximum mouth opening in mm, using Castroviejo instrument.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
effect of locking and non locking suture technique on trismus	Trismus will be evaluated by measuring the distance between the mesio-incisal corners of the upper and lower right central incisors at maximum mouth opening in mm, using Castroviejo instrument.	3 days and 7 days post operatively
Effect of locking and unlocking sutures on facial swelling	The facial swelling in cm will be determined by measuring the distance from the corner of the mouth to the attachment of the earlobe following the bulge of the cheek and the distance from the outer canthus of the eye to the angle of the mandible using a plastic measuring tape.	Post operative day three and day seven

Collaborators and Investigators

• Sponsor: Watim Medical & Dental College

Study record dates

Study Major Dates

• Study Start (Estimated): July 1, 2026
• Primary Completion (Estimated): January 31, 2027
• Study Completion (Estimated): January 31, 2027

Study Registration Dates

• First Submitted: November 18, 2025
• First Submitted That Met QC Criteria: December 25, 2025
• First Posted (Actual): January 8, 2026

Study Record Updates

• Last Update Posted (Actual): January 8, 2026
• Last Update Submitted That Met QC Criteria: December 25, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Neuromuscular Manifestations; Spasm; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Trismus
• Other Study ID Numbers: WMDCR/ERB/2023/50

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No