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

NCT07327762 | Not Yet Recruiting DMC

• 1 other identifier: WMDCR/ERB/2023/50
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Swelling; Trismus

Outcome Measures

Primary Outcomes (2)

• 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

Study Arms (2)

locking suture

EXPERIMENTAL

effect of locking suture on trismus and swelling

Procedure: locking and non locking suture techniques; Procedure: non locking suture technique

non locking suture

EXPERIMENTAL

effect of non locking suture on trismus and swelling

Procedure: locking and non locking suture techniques; Procedure: non locking suture technique

Interventions

non locking suture technique PROCEDURE

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.

locking suture; non locking suture

locking and non locking suture techniques PROCEDURE

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

locking suture; non locking suture

Eligibility Criteria

• Age: Up to 45 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

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

You may not qualify if:

• 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.

Sponsors & Collaborators

• Watim Medical & Dental College: lead

Study Sites (1)

Watim Medical and Dental College

Rawalpindi, Pakistan, 46200, Pakistan

Location

MeSH Terms

Conditions

Trismus

Condition Hierarchy (Ancestors)

Spasm; Neuromuscular Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: Masking Description
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: By undertaking a comparative analysis of two distinct suture knot techniques, this study seeks to address this knowledge gap and provide evidence-based insights into the optimal approach for wound closure in impacted third molar surgery. Understanding the differential effects of suture techniques on postoperative trismus and swelling is essential for informing clinical decision-making, guiding surgical practices, and ultimately enhancing patient care. Postoperative complications are common after this surgery and can be attributed to various factors.

Study Record Dates

• First Submitted: November 18, 2025
• First Posted: January 8, 2026
• Study Start (Estimated): July 1, 2026
• Primary Completion (Estimated): January 31, 2027
• Study Completion (Estimated): January 31, 2027
• Last Updated: January 8, 2026

Record last verified: 2025-12

Locations

PA (1)