Microbiological Analysis of Bacterial Plaque on Various Suture Types Used in Third Molar Surgical Extraction: a Systematic Review

Objectives: The aim of this systematic review is to assess how different types of surgical sutures impact the microbiological composition of bacterial plaque in patients undergoing impacted third molar teeth removal surgery.

Material and Methods: This systematic review followed PRISMA guidelines. Electronic literature searches were conducted across PubMed, Google Scholar, ResearchGate, and Web of Science databases, employing electronic databases and hand searches. Keywords such as “suture”, “third molar”, “wisdom teeth”, “impacted teeth”, “surgical extraction” were used in various combinations with Boolean operators. A 10-year filter, English language, and full-text access filter were applied. The research spanned the period from January 1, 2016, to January 1, 2025, and incorporated studies on humans published in English.

Results: The systematic literature review included 11 studies with 649 suture samples from 360 patients undergoing impacted third molar removal surgery. Twenty-five suture types were used, with silk being the most common but often accumulating the highest bacterial load. Prolene^® and antibacterial sutures, like Monocryl^® Plus, showed significantly lower bacterial colonization.

Conclusions: Sutures after third molar surgery can promote bacterial attachment, potentially leading to infections that impact wound healing. The evidence suggests that monofilament, synthetic, and antibacterial-coated sutures are preferable for reducing bacterial colonization, whereas multifilament silk sutures should be avoided when possible due to their high bacterial retention.

J Oral Maxillofac Res 2025;16(2):e3

doi: 10.5037/jomr.2025.16203

Accepted for publication: 29 June 2025

Keywords: bacteria; impacted teeth; microbiology; oral surgery; sutures; third molar.