The evaluation of tissue reactions formed at gingiva by different suture materials

The most important component of a successful oral surgery is the clean, healthy and durable knitting of the incision edges. A wide variety of the suturing materials are used for this purpose. The sutures as like the other synthetic implants placed inside the body are suitable foci for the adherence and colonization of microorganisms. Just after the placement, surface of the suture material is covered with substrats such as fibrinogen, collagen and fibronectin. These substrates serve as an adhesine for the microbial attachment. The wound surface is thus contaminated and may result in an infection. Infection of the wound areas will prolong the inflammatory process and delay the recovery phase. The tissue reaction against the suturing materials is an important factor during the recovery to decide the best among the many available materials.The purpose of our study is to investigate and compare the tissue reactions of the oral mucosa due to the suture materials with different structure and antibacterial effects Fifteen patients with at least four adjacent teeth that required surgical crown lengthening procedure or extraction prior to restorative work participated the study. The mean age of the patients was 56.3±15.64. Three sutures of different properties were placed in the interdental areas of the teeth: polyglactine 910 (vicryl), polyglactine 910 coated with triclosan (vicryl plus), polyglecaprone 25 (monocryl). During the process and on the 7th day, the measurements for tissue width and suture slack were recorded. After one week 3x3mm soft tissue specimens were excised while the sutures were in situ and were fixed in 10% buffered formaldehyde. Inflammatory area and density of inflammatory cells were evaluated histopathologically. On the 7th day, the clinical measurements demonstrated that there was no statistically difference in the gliding capacity between the materials. The monocryl suture material was found significantly worse in about the knot security when compared to the other materials. In the histopathological evaluation, it was determined that the vicryl plus suture materials gave similar results to the monocryl sutures in regard to the inflammatory response and was superior to vicryl suture materials regarding the tissue reaction.