Comparison of four different suture materials in respect to oral wound healing, microbial colonization, tissue reaction and clinical features—randomized clinical study

• Published in: Clinical oral investigations Vol. 24; no. 4; pp. 1527 - 1541
• Main Authors: Dragovic, Miroslav, Pejovic, Marko, Stepic, Jelena, Colic, Snjezana, Dozic, Branko, Dragovic, Svetlana, Lazarevic, Milos, Nikolic, Nadja, Milasin, Jelena, Milicic, Biljana
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-04-2020; Springer Nature B.V
• Subjects: Colonization; Dentistry; Inflammation; Medical equipment; Medicine; Original Article; Polypropylene; Postoperative infection; Silk; Surgery; Sutures; Teeth; Wound healing; Sutures; Microbial adherence; Inflammatory reactions; Monofilament; Soft tissue healing; Oral surgery
• ISSN: 1432-6981; 1436-3771
• DOI: 10.1007/s00784-019-03034-4

Objectives
Sutures are the most frequently used medical device for wound closure. They support tissue during the early phase of healing until it regains enough tensile strength. The aim of this study was to compare four different suture materials in terms of the influence on wound healing, microbial adherence, tissue reaction, and relevant clinical parameters which determine their clinical value.
Materials and Methods
Total number of 32 patients undergoing surgical extraction of four impacted third molars were involved in the study. Clinical parameters were estimated intraoperatively and during the control check-ups. Soft tissue healing around sutures were evaluated on the 3rd and 7th day postoperatively. Microbial colonization was assessed by means of qPCR. Also, histological analysis was done to assess inflammatory reaction.
Results
Significantly better soft tissue healing was found around monofilament and synthetic sutures compared to multifilament and natural ones respectively. Soft tissue healing was significantly better around all sutures on the 7th day than on the 3rd day postoperatively.
Conclusions
Non-resorbable polypropylene suture showed superior clinical characteristics among all sutures. Moreover, the best healing of soft tissue and the least inflammatory reaction was found around this thread. The poorest soft tissue healing was found around non-resorbable silk suture. This suture elicited strongest inflammatory reaction and showed the greatest microbial adherence affinity compared to alternative sutures.
Clinical relevance
Monofilament synthetic suture should be used in order to obtain the best soft tissue healing, reduce the risk of postoperative infection, and alleviate the suturing after oral surgery procedures.