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ADF Health October 2005 - Volume 6 Number 2

Clinical tip

Intra-oral suture removal

Common sites for sutures following mandibular third molar removal

Common sites for sutures following maxillary third molar removal Adapted from Geoffrey L Howe, Minor Oral Surgery. London: Wright, 1985.

Access

Visualising intra-oral sutures is often not easy, especially in the posterior mandibular region and the posterior maxillary tuberosity areas. If possible, have an assistant to help manage retraction of cheek and tongue, preferably with cheek and tongue retractors.

A dental light or bright, narrow-beamed torch will be required. If a dental light is unavailable, an assistant will be needed to hold and adjust the torch as required.

Suture location

Ask your patient how many sutures were placed, and whether they can feel them with their tongue. Your patient is often your best guide to suture location, especially if intra-oral anatomy has been altered by post-operative swelling or injury.

Third molar sutures

Mandibular third molar sutures: Look for sutures in the posterior mandibular area near the ascending ramus of the mandible in the region of the pterygomandibular raphe, and in the buccal sulcus adjacent to the lower first or second molar tooth. There will often be multiple sutures in the raphe area.

Maxillary third molar sutures: Look for sutures in the posterior maxillary area near maxillary tuberosity and in the region of the buccal sulcus adjacent to the upper second molar tooth.

Lieutenant Colonel Rosemary Landy, BDSc, DipCIDOFAGO
S01 Health Policy, Directorate of Clinical Policy, Defence Health Service.