A comparative assessment between analgesic and non analgesic coated suture material in evaluation of post extraction pain and healing : A prospective split mouth study

Wound repair is a well orchestrated and highly coordinated process. Sutures serve to maintain tissue approximation until the wound attains sufficient tensional strength to prevent dehiscence. Correct closure and stabilization of surgical wound margins influence the success of the surgical procedure. The number of tissue layers involved in wound closure, the amount of tension across the sutured wound, the depth at which the suture is placed, the presence of edema, the approximate amount of time the suture must be kept in place, and the inflammatory reactions displayed by the suture material are some of the factors that influence the choice of suture material in the management of surgical wounds.  Post extraction pain has often been a nemesis for dental surgeons,with clinicians perpetually striving for an analgesic modality that would provide profound analgesia and would be best tolerated by the patient, hence ensuring patient compliance. Medications such as NSAIDS are frequently provided to patients experiencing post-surgical pain and are to be taken orally or parentarally.Long term repeated medication administrations are necessary as long term pain lasts until the wounds have nearly healed. Gastrointestinal disturbances, Electrolytic imbalance, Fluid retention hypertension, Hyperkalemia, Hyponatremia, Reye’s syndrome, Platelet dysfunction and Renal impairment are just a few of the side effects. Since oral medications must first pass through the liver for metabolism, there will be less bioavailability and due to high plasma concentration which leads to significant adverse effects, local  drug delivery is advantageous for reducing pain at the surgical site. Ketorolac tromethamine is a pyrrolo -pyrrole non steroidal anti inflammatory drug with potent analgesic, anti inflammatory and antipyretic activity. Mechanism of action of Ketorolac is by inhibiting the cycloxygenase pathway of arachidonic acid metabolism, resulting in a decrease in prostaglandin and thromboxane production. Therefore, Analgesic-coated suture can be used as a medical aid potentially suitable for local drug delivery to treat post-surgical pain.

In this study, we will be comparing Analgesic coated suture- Ketorolac tromethamine and Non Analgesic coated suture Vicryl 3-0 post extraction to provide local drug delivery to alleviate pain and assess healing in patients by two interventions.