This study aims to compare slow-resorbing and fast-resorbing sutures used after the surgical extraction of lower third molars. Sutures are routinely placed after wisdom tooth removal to promote hemostasis. Slow-resorbing and fast-resorbing sutures differ mainly in how long they remain in place, and fast-resorbing sutures often do not require removal. The study evaluates whether these two types of sutures differ in terms of microbiological contamination. Patient-reported inflammation, swelling, and postoperative discomfort will also be assessed.
Each participant will be randomly assigned to receive one of the two suture types. Only routine clinical procedures are involved. Participation includes several standard visits: initial medical and dental history collection with oral and radiographic examination; the surgical extraction of the lower third molar; suture removal at 7 days. No additional invasive procedures are required.
Participants will receive a daily diary to record pain levels and any pain medication taken during the first postoperative week. At the 7-day visit, wound healing will be evaluated and sutures will be removed, collected and anonymously analyzed by the University Microbiology Laboratory.
This study seeks to provide useful information about the clinical performance and microbiological behavior of different types of resorbable sutures commonly used in oral surgery, with the goal of improving patient care and postoperative outcomes.
non smoker patients
clinical indication to third molar surgical removal
patients who are able to express informed consent
smokers
pregnant female
subjects treated with medications that affect bone metabolism
Parallel
Fast absorbable sutures application
DeviceFast absorbable sutures application on experimental group
Standard absorbable sutures application
DeviceStandard absorbable sutures application will be applied on control group
Microbiological evaluation of the sutures
After seven days, one operator will remove the sutures and immediately place them in a sterile, pre-weighed tube containing 1 ml of Brain Heart Infusion broth (BHI, Thermo Fisher, Waltham, USA), avoiding external contamination. Samples will be immediately transported to the microbiology laboratory, weighed, vortexed, and seeded on blood agar (BA), anaerobe blood agar (CDC), chocolate agar (CA), and Mitis salivarius agar (MSA), under anaerobic and aerobic conditions at 37°C for 24 hours. The bacterial load will be quantified as colony-forming units per millilitre (CFU/ml) and normalised by the weight of the sample.
Clinician evaluation
From the clinician's perspective, they will be required to report, on a VAS scale, the level of difficulty encountered during suture removal at 7 days post-surgery, which will be performed using sterile scissors and forceps. The Visual Analog Scale (VAS) is used with values ranging from 1 to 10, where 1 corresponds to the minimum value (minimal difficulty for the operator) and 10 corresponds to the maximum value (maximum difficulty for the operator), with 2-9 representing intermediate values.
Patient reported outcomes
From the patient's perspective, a VAS (Visual Analogue Scale) will be used to subjectively assess the discomfort during the 7 days in which the sutures remain in the mouth, as well as the pain associated with their removal after 7 days. The Visual Analog Scale (VAS) is used with values ranging from 1 to 10, where 1 corresponds to the minimum value (minimal discomfort for the patient) and 10 corresponds to the maximum value (maximum discomfort for the patient), with 2-9 representing intermediate values.
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