Application of tissue adhesive vs silk suture for primary closure of surgical flaps after lower third molar extraction: a split mouth study

Background: despite being the common choice for closing wounds following third molar extraction, sutures come with issues such as needle-induced trauma, increased bleeding, swelling, discomfort, and the risk of scar tissue, infection and necrosis. This study explores the potential of replacing 3/0 Silk Sutures with Ifabond® Glue. Methods: a split-mouth study was conducted on 25 adult patients who required extraction of both mandibular third molars. Wound closure was randomly assigned, one side was closed using Ifabond® Glue and the other with 3/0 silk sutures. Patients monitored postoperative pain level, bleeding, and painkiller intake through a questionnaire. Follow-up assessments at 1 week and 10 months were carried out. Results: no side effects were reported after use of cyanoacrylate adhesive. Wound infections were absent, there was one case of temporary facial paraesthesia. Regarding second molar periodontal status, Ifabond® Glue showed effective wound closure. Post-operative bleeding, pain perception and painkiller intake displayed no differences between test and control sites. Conclusions: Ifabond® Glue proves non-inferior to traditional sutures for wound closure, showing promise for fewer postoperative complications. It is important to note that these findings are preliminary, and a larger sample size and further testing are needed to validate these observations. Key words: suture, Ifabond® Glue, inferior third molars, mandibular third molars, third molar extraction.