Background: Closing the surgical incision is a critical step in surgical procedures. The clinical success of surgery can sometimes be compromised by defective suturing techniques or improper choice of biomaterials. Silk sutures are historically among the most frequently utilized materials in day-to-day intraoral surgical interventions [1]. The purpose of this prospective study was to clinically evaluate and compare the efficacy of antibacterial polyglactin 910 (Vicryl Plus) sutures against conventional black silk sutures for wound closure following the surgical removal of impacted lower third molars.

Materials & Methods: This prospective clinical study was conducted among 50 patients visiting the outpatient wing of the Department of Dentistry at ( Institution name blinded for peer review). Fifty patients aged between 18 and 35 years requiring unilateral surgical extraction of an impacted mandibular third molar were enrolled. Patients were allocated using a computer-generated randomization list into two equal groups of 25 each. Group A received 3-0 silk sutures, and Group B received 3-0 Vicryl Plus sutures for primary closure of the surgical site. Standardization of the surgical procedure was maintained by utilizing a consistent modified Ward’s incision design, standardized bone removal protocols, and placing exactly three simple interrupted sutures per site. Clinical parameters including postoperative pain (evaluated via a Categorical Pain Scale), maximum mouth opening (MMO), and facial edema were assessed at baseline (pre-op) and postoperatively on the 3rd and 7th days.

Results: Both groups demonstrated a return of facial edema levels to baseline values by the 7th post-operative day, with maximal edema objectively recorded on the 3rd post-operative day. However, significantly lower facial edema scores were observed in the Vicryl Plus group compared to the silk group on both day 3 and day 7 (P < 0.00001). Categorical pain scores were also statistically lower in the Vicryl Plus cohort at all post-operative follow-up intervals (P < 0.00001). Concurrently, MMO was significantly higher in the Vicryl Plus group on the 3rd and 7th post-operative days (P < 0.00001 and P = 0.00011, respectively).

Conclusion: The study concluded that Vicryl Plus antibacterial sutures provide a statistically superior clinical outcome for intraoral wound closure compared to conventional silk sutures, demonstrating a notable reduction in postoperative morbidity including swelling, pain, and trismus.