Effectiveness of Metronidazole-coated Silk Sutures Versus Conventional Silk Sutures in Healing of Wound after Disimpaction Surgery of Mandibular Third Molars: A Randomized Control Trial

Background: Wound healing after the surgical removal of the impacted mandibular third molar is often adversely affected by microbial contamination and postoperative inflammation. Suturing the wound may provide a nidus for bacterial colonization, compromising wound healing. Silk sutures, which are impregnated with metronidazole, provide potent anaerobic antimicrobial properties, help to reduce local infection and promote better wound healing. This study aims to evaluate the effectiveness of metronidazole-coated silk sutures in reducing postoperative sequelae following mandibular third molar removal. Materials and Methods: This randomized control trial enrolled 34 healthy volunteers undergoing mandibular third molar disimpaction surgery. They were randomly divided into study group (metronidazole-coated silk sutures) and control group (conventional silk sutures) and were sutured accordingly. Postoperative healing was assessed on Days 1 (24 h), 3 and 7. Results: The study group showed a statistically significant improvement in scores from Day 1 to Day 3 and Day 7 ( P < 0.01), with a significant reduction in bleeding on palpation and granulation tissue by Day 7 ( P = 0.031). The control group showed significant improvement mainly by Day 7 ( P < 0.01). Intergroup comparison revealed significantly superior and faster healing in the case group on Day 3 ( P = 0.005) and Day 7 ( P = 0.049). Conclusion: Wounds closed by metronidazole-coated silk sutures heal faster than conventional silk sutures in patients with mandibular third molar disimpaction surgery.