Comparison of Suturing Techniques on Wound Healing and Patient-Centered Outcomes After Non-impacted Tooth Extraction:...

Successful wound closure after tooth extraction is important for postoperative healing and patient comfort. Different suturing techniques may influence tissue approximation, wound stability, postoperative inflammation, and patient-centered outcomes. The present study aimed to compare the effects of simple interrupted suturing (SIS), figure-of-eight suturing (F8S), and horizontal mattress suturing (HMS) on postoperative wound healing and patient-related clinical outcomes following routine non-impacted tooth extraction.

This prospective observational cohort study included 150 participants requiring routine non-impacted tooth extraction, with 50 participants enrolled in each suturing group: SIS, F8S, and HMS. Group assignment was based on surgeon preference and patient choice. Soft tissue healing was assessed using the early wound healing score on postoperative days 1, 3, 7, and 14. Secondary outcomes included postoperative pain (assessed using the visual analog scale), edema, postoperative bleeding, wound dehiscence, suture handling time, and patient satisfaction. All statistical analyses were performed using IBM SPSS Statistics for Windows, Version 23 (Released 2016; IBM Corp., Armonk, New York, United States), with a significance level set at p < 0.05.

Baseline demographic and clinical characteristics were comparable between the groups (p > 0.05). Early wound healing scores progressively improved over time in all groups. However, the HMS group had the highest healing scores, followed by the SIS group. On postoperative day 14, healing scores were 9.7 ± 0.4 for HMS, 9.6 ± 0.5 for SIS, and 8.9 ± 0.8 for F8S. On postoperative day 1, pain scores were highest in the F8S group (5.82 ± 1.41) compared with the SIS (4.25 ± 1.23) and HMS (3.98 ± 1.15) groups. Edema, postoperative bleeding, and wound dehiscence were also significantly greater in the F8S group (p < 0.05). Although F8S required the shortest handling time (52.1 ± 9.7 seconds), patient satisfaction was significantly lower compared with the other groups.

Within the limitations of this study, SIS and HMS demonstrated superior postoperative healing and patient-centered outcomes compared with F8S following routine tooth extraction. HMS showed the most favorable healing profile, whereas F8S, despite requiring shorter operative time, was associated with inferior postoperative outcomes.