Effects of cold plasma systems applied to sutures used in third molar surgery on postoperative sequelae and quality of life: a randomized pilot clinical trial

To evaluate whether cold atmospheric plasma (CAP) and argon-assisted cold atmospheric plasma (CAP-Ar) treatment of silk and polytetrafluoroethylene (PTFE) sutures influences postoperative sequelae and oral health-related quality of life after mandibular third molar surgery. In this single-center randomized pilot clinical trial, 60 adults undergoing impacted mandibular third molar surgery were allocated to six groups: silk, silk-CAP, silk-CAP-Ar, PTFE, PTFE-CAP, and PTFE-CAP-Ar ( n = 10 per group). CAP or CAP-Ar was applied to 5-cm segments of the assigned suture material for 60 s immediately before wound closure. Postoperative pain was assessed using a visual analog scale, facial swelling by three-dimensional facial scanning, mouth opening clinically, and oral health-related quality of life using the OHIP-14 questionnaire at predefined postoperative time points. Sixty participants were included in the analysis. No statistically significant between-group differences were observed for postoperative pain, facial swelling, mouth opening, or OHIP-14 scores at any evaluated time point ( p > 0.05). Under the conditions of this pilot trial, neither suture material (silk vs. PTFE) nor plasma treatment (CAP or CAP-Ar) significantly improved postoperative sequelae or oral health-related quality of life after mandibular third molar surgery. These preliminary findings should be confirmed in larger definitive randomized clinical trials. In this pilot sample, plasma treatment of silk or PTFE sutures does not appear to provide a measurable short-term clinical benefit in routine mandibular third molar surgery.