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Randomized Controlled Trial
. 2025 Aug 11;29(1):141.
doi: 10.1007/s10006-025-01438-z.

Comparative evaluation of V-Loc knotless closure system and silk sutures in impacted mandibular third molar surgery: a split-mouth randomized controlled trial

Krithic Chithra Banu Vijayakumar  1 , Geetha Sridharan  2 , Tangutur Srinivasa Prasad  3 , Megarasu Deepanjali  3 , Bhuvaneshwari Parthasarathy  3 , Nissi Evelyn R  4
Affiliations
Randomized Controlled Trial

Comparative evaluation of V-Loc knotless closure system and silk sutures in impacted mandibular third molar surgery: a split-mouth randomized controlled trial

Krithic Chithra Banu Vijayakumar et al. Oral Maxillofac Surg. .

Abstract

Purpose: Sutures are the most frequently utilized to ensure a watertight seal, reposition the flap to its natural alignment, provide mechanical stability to secure tissues during the early healing phase, and reduce the risk of postoperative complications. This study aimed to evaluate and compare the effectiveness of the V-Loc Poly (p-dioxanone) knotless Tissue Control Device wound closure system and conventional silk suture in intra-oral closure following surgical removal of impacted mandibular third molar.

Methods: This is a prospective randomized split-mouth study involving 17 patients with bilateral mirror image third molars, one side received V- Loc unidirectional knotless barbed sutures while the other received silk sutures for the study and control group on a week's interval accordingly. The primary outcome parameter measured was wound closure time. Secondary outcome parameters measured were mouth opening, swelling, wound healing (Landry's index), and pain. The secondary outcome parameters were assessed on the 3rd, 5th, 7th, and 14th postoperative days.

Results: The closure time showed a statistically significant difference, with an average time difference of 1.3 min. Additionally, wound healing was significantly different between the study and control groups on postoperative day 3 (p = 0.019) and day 14 (p < 0.001).

Conclusion: This absorbable knotless suture promotes efficient wound healing and prevents postoperative complications like infections or dry socket. The time taken for the closure of the socket is longer when a knotless suture is placed, though this technique has a learning curve that is generally short to moderate, which takes an average of 3-5 cases for the clinicians to adapt, and with a brief demonstration or by watching a technique video.

Trial registration: Clinical Trial Registry, India, (ICMRNIMS) (registration No CTRI/2024/04/065383).

Keywords: Impacted tooth; Poly-p-dioxanone; Silk sutures; Unidirectional barbed suture; V-Loc knotless; Wound closure.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethical approval: All procedures performed in studies involving human participants followed the ethical standards of the institutional and/or national research committee and were performed in accordance with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Meenakshi Ammal Dental College. The Institutional Review Board has approved the study by providing an ethical clearance number (MADC/IEC/III/75/2023). Consent to participate: Informed consent was obtained from all individual participants included in the study.

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