Vasanthan Asvin, Satheesh Keerthana, Hoopes Wyeth, Lucaci Patrick, Williams Karen, Rapley John
Department of Periodontics, University of Missouri-Kansas City School of Dentistry, Kansas City, MO.
J Periodontol. 2009 Apr;80(4):618-24. doi: 10.1902/jop.2009.080490.
The purpose of this study was to compare the tensile strengths of commonly used sutures over a 2-week period under simulated oral conditions.
Three suture materials (chromic gut [CG], polyglactin [PG], and polyglactin-fast absorbing [PG-FA]) were used in 4-0 and 5-0 gauges. After pretensioning, 252 suture samples (42 of each material and gauge) were used. A biologic simulation was created in vitro by mixing 9 ml sterile human saliva and human serum in a 1:1 ratio in a petri dish maintained at a pH of 7.4 to 8.1 at 37 degrees C. All samples were tested preimmersion and 1 hour and 1, 3, 7, 10, and 14 days postimmersion. The tensile strength was assessed using a microtensile tester, and the maximum load required to cause suture breakage was determined. The point of breakage in the samples and the samples themselves were also assessed.
During the first 24 hours of immersion, all 4-0 and 5-0 samples of CG and PG maintained their initial level of tensile strength; PG-FA 5-0 decreased in strength, which was statistically significant (P = 0.001). Between days 1 and 3, the tensile strength of PG and PG-FA decreased significantly, with PG-FA 5-0 showing a greater and more precipitous decrease than PG-FA 4-0; the tensile strength of CG changed little during this time. After 7 days of immersion, PG 4-0 had significantly greater tensile strength than CG, and both were significantly greater than that of PG-FA. By day 10, CG and PG had statistically greater strength (P = 0.01) than PG-FA, and values were similar for the 4-0 and 5-0 gauge materials. All samples of PG-FA 5-0 and most samples of the PG-FA 4-0 exhibited 0.00 N strength (i.e., they had disintegrated) at the 10- and 14-day periods of evaluation.
4-0 sutures are stronger and have greater tensile strength than 5-0 sutures. CG seems to sustain its strength better than PG and PG-FA after 2 weeks. PG-FA may not be a desirable suture if tensile strength is required after 10 days. Appropriately designed clinical studies are necessary to confirm this finding in an in vivo environment.
本研究的目的是在模拟口腔条件下比较常用缝线在2周时间内的抗张强度。
使用三种缝线材料（铬制肠线[CG]、聚乙醇酸[PG]和快速吸收聚乙醇酸[PG-FA]），规格为4-0和5-0。预张紧后，使用252个缝线样本（每种材料和规格各42个）。通过在37摄氏度下将9毫升无菌人唾液和人血清按1:1比例混合在培养皿中，使其pH值保持在7.4至8.1，在体外创建生物模拟环境。所有样本在浸泡前、浸泡后1小时以及浸泡后1、3、7、10和14天进行测试。使用微拉伸测试仪评估抗张强度，并确定导致缝线断裂所需的最大负荷。还对样本中的断裂点和样本本身进行了评估。
在浸泡的前24小时内，CG和PG的所有4-0和5-0样本均保持其初始抗张强度水平；PG-FA 5-0的强度下降，差异具有统计学意义（P = 0.001）。在第1天至第3天之间，PG和PG-FA的抗张强度显著下降，PG-FA 5-0的下降幅度比PG-FA 4-0更大且更急剧；在此期间，CG的抗张强度变化不大。浸泡7天后，PG 4-0的抗张强度显著高于CG，且两者均显著高于PG-FA。到第10天，CG和PG的强度在统计学上高于PG-FA（P = 0.01），4-0和5-0规格材料的值相似。在评估的第10天和第14天，PG-FA 5-0的所有样本以及PG-FA 4-0的大多数样本均表现出0.00 N的强度（即它们已经分解）。
4-0缝线比5-0缝线更强且具有更大的抗张强度。2周后，CG似乎比PG和PG-FA更好地保持其强度。如果在10天后需要抗张强度，PG-FA可能不是理想的缝线。需要进行适当设计的临床研究以在体内环境中证实这一发现。
