Cyanoacrylate Adhesive in Impacted Mandibular Third Molars Surgery

Surgical removal of impacted mandibular third molars is one of the most common procedures in dental practice. Following surgery, conventional wound closure using sutures is widely employed to support healing. However, this method has several limitations, including difficult surgical access to the posterior oral cavity, tissue trauma during suturing, plaque accumulation around the suture site, and the need for suture removal after surgery. These drawbacks create a need for alternative wound-closure approaches. Recently, the development of biomaterials, particularly cyanoacrylate tissue adhesives has introduced a new strategy that may improve healing and reduce postoperative complications. Cyanoacrylate tissue adhesives have been reported to possess favorable biological properties, including antibacterial activity, hemostatic capability, biodegradability, and biocompatibility with living tissues. Various cyanoacrylate derivatives have been investigated, ranging from methyl, ethyl, and propyl to butyl and octyl cyanoacrylate, among which butyl and octyl forms demonstrate the most favorable clinical performance. In oral surgery, cyanoacrylate has been recognized as a useful alternative due to its ability to shorten operative time, reduce postoperative pain, and eliminate the need for suture removal after healing. Lascaz Netto and Macedo (1986) evaluated wound healing in patients using cyanoacrylate for gingival graft fixation and reported significantly reduced surgical time with normal postoperative recovery. Cyanoacrylate adhesives have also been applied for multiple clinical purposes, including periodontal dressing, closure of sinus membrane perforations, fixation of bone fragments in fracture surgery, and peripheral nerve repair. In addition, cyanoacrylate has been proposed for wound closure via primary healing and, more recently, for protection of wounds healing by secondary intention. Although cyanoacrylate tissue adhesives have been widely studied and applied in medicine, limited evidence exists regarding their effectiveness in supporting soft-tissue healing and their impact on the local oral microbiological environment. Moreover, few studies have directly compared tissue adhesives with conventional suturing across multiple bacterial species using modern analytical techniques. Therefore, this study was conducted to evaluate the soft-tissue healing support provided by cyanoacrylate tissue adhesive compared with traditional sutures through three aspects: common postoperative complications (pain, swelling, and trismus), the rate of soft-tissue healing, and changes in the microbiological profile at the surgical site.