Tissue Reactions to Various Suture Materials Used in Oral Surgical Interventions

Abstract

Introduction: Suturing is one of the main techniques performed in most dental surgeries. Nowadays,black silk is the most widely used suture because it is cheap and easy to use clinically. We need to evaluate its effectiveness. Objectives: The main objective was to establish the best suture materials in gingival surgery for an esthetic result and to minimize the tissue reaction. To develop,we used secondary objectives as follow: to compare the tissue reaction between monofilament and multifilament,find the ideal diameter of the suture as well as the needle appropriated for each procedure. Material and Method: With our research question a literature review was carried out through MEDLINE complete and Google scholar. The research was limited to full articles published since 2013. Results: Applying the established inclusion and exclusion criteria,a total of 44 studies were included in the review. Conclusions: Black silk should not be the main suturing material in dentistry,due to its natural multifilament structure,it is more susceptible for plaque accumulation and inflammation of adjacent tissues. More recent studies suggest using monofilament synthetics material such as Nylon or multifilament synthetic as the Polyglactin,to minimize tissue reaction and avoid scarring. The ideal suture diameter is always the thinnest possible compared to the strength and thickness of the tissue. The more commonly used are diameter 4-0 in the oral cavity. Finally,the needle should pass through the tissue but not tear it. The more used are the triangular “reverse cutting” needles. Due to the narrow arreas,we need to use curved needles in the oral cavity. The ideal curvature is 3/8 of a circle because it has more maneuverability and good penetration with just a swing wrist movement from buccal to lingual or palatal