Using a triangular flap without a buccal suture appears to be a preferable option for reducing pain and improving patient satisfaction in the first 3 days after surgery, providing a simple and feasible alternative in clinical practice.

A three-arm randomized clinical trial aimed to investigate whether reducing the number of sutures can enhance the quality of life following extraction of the lower third molar.

In this study, a total of 90 individuals were incorporated and randomly assigned to 3 groups: the no-suture group, the buccal drainage group, and the airtight suture group (traditional). Postoperative measurements, such as postoperative patient quality of life questionnaire, visual analog scale (VAS) ratings, time of the treatment, as well as details regarding dry socket, swelling, trismus, and other complications, were collected twice and the recording of mean values was done.

The data were assessed for normal distribution using the Shapiro-Wilk test. Utilizing one-way ANOVA and the Kruskal-Wallis test with Bonferroni post-hoc correction, the analysis of statistical differences was done.

On the third day postoperatively, the buccal drainage group exhibited a significant reduction in pain and improved speech ability compared to the no-suture group, with mean scores of 1.3 and 0.7 respectively. Similarly, the airtight suture group also demonstrated improved eating and speech ability, surpassing the no-suture group with mean scores of 0.6 and 0.7.

No significant betterment was observed on the first and seventh days. There were no statistically significant differences among the 3 groups in terms of surgical treatment time, postoperative social isolation, sleep impairment, physical appearance, trismus, and swelling at all measured time points.

The triangular flap technique without a buccal suture appears to offer advantages over both the traditional and no-suture approaches. It demonstrates reduced pain and improved postoperative patient satisfaction within the initial 3-day period, making it a potentially straightforward and effective choice in clinical practice.