Yaman Deniz, Paksoy Tuğçe, Ustaoğlu Gülbahar, Demirci Mehmet
Assistant Professor, Department of Oral and Maxillofacial Surgery, Bolu Abant Izzet Baysal University, Faculty of Dentistry, Bolu, Turkey.
Assistant Professor, Department of Periodontology, Beykent University, Faculty of Dentistry, Istanbul, Turkey.
J Oral Maxillofac Surg. 2022 Feb;80(2):313-326. doi: 10.1016/j.joms.2021.09.014. Epub 2021 Sep 21.
This study aimed to compare the effects of 10 different suture materials commonly used in dentoalveolar surgery on wound healing, their postoperative microbial colonization, and related clinical parameters.
A total of 172 suture samples from patients who had undergone extraction of impacted third molars were included in the study. The suture materials studied were poly-glycolide-colactide, fast absorbable poly-glycolide-colactide, poly-glycolic acid-cocaprolactone, polydioxanone, silk, polypropylene, polyvinylidene difluoride, polyamide, polyester, and polytetrafluoroethylene (PTFE). The microbial colonization in all sutures and clinical parameters were evaluated after 1 week.
Multifilament sutures had higher bacterial colonization compared with monofilament sutures (P < .001). No dental plaque accumulation was observed in any samples of polypropylene sutures. Polydioxanone, PTFE, and poly-glycolic acid-cocaprolactone sutures exhibited less postoperative slack compared with all other sutures after 1 week. Patients with silk, polyvinylidene difluoride, and PTFE sutures had less suture-related discomfort. According to the Landry index score, monofilament sutures demonstrated superior wound healing to multifilament sutures (P = .019). In addition, nonabsorbable sutures showed significantly better wound epithelization than absorbable sutures (P ˂ .001).
Bacterial colonization and tissue reactions due to the surface properties of the suture affected the wound healing after dentoalveolar surgery. Multifilament sutures should not be applied for prolonged periods because of their tendency for microbial colonization. The tissue reaction to the absorbable suture materials may adversely affect wound healing.
本研究旨在比较牙槽外科中常用的10种不同缝合材料对伤口愈合、术后微生物定植及相关临床参数的影响。
本研究纳入了172例接受阻生第三磨牙拔除术患者的缝合样本。所研究的缝合材料有聚乙交酯-丙交酯、快速吸收聚乙交酯-丙交酯、聚乙醇酸-己内酯、聚二氧六环酮、丝线、聚丙烯、聚偏二氟乙烯、聚酰胺、聚酯和聚四氟乙烯(PTFE)。1周后评估所有缝合线的微生物定植情况及临床参数。
与单丝缝合线相比,多丝缝合线的细菌定植率更高(P <.001)。在聚丙烯缝合线的任何样本中均未观察到牙菌斑积聚。1周后,聚二氧六环酮、聚四氟乙烯和聚乙醇酸-己内酯缝合线与所有其他缝合线相比,术后松弛度更小。使用丝线、聚偏二氟乙烯和聚四氟乙烯缝合线的患者缝合相关不适较少。根据兰德里指数评分,单丝缝合线的伤口愈合情况优于多丝缝合线(P =.019)。此外,不可吸收缝合线的伤口上皮化明显优于可吸收缝合线(P ˂.001)。
缝合线表面特性引起的细菌定植和组织反应影响了牙槽外科手术后的伤口愈合。由于多丝缝合线有微生物定植的倾向,不应长期使用。可吸收缝合材料引起的组织反应可能对伤口愈合产生不利影响。