Review Article

Tissue Reactions to Various Suture Materials Used in Oral Surgical Interventions

Table 1

Authors, study design, types of oral surgery, suture material sued, statistical methods, and main results of selected studies.

Authors et al. YearStudy designSubjectsType of procedureSuture material usedMain results/conclusions

Yilmaz et al. 2010 [7]ExperimentalAnimal modelOral mucosal surgery (buccal mucosa)Silk, catgut, and Polyglecaprone 25Activities of silk and catgut were similar in both diabetic and control groups. All of the materials were well tolerated; however, polyglecaprone 25 had more positive effects on wound healing compared to others.

Sortino et al. 2008 [8]ClinicalHumanOral surgerySilk and PGASilk sutures presented a better tension compared to the PGA sutures. There was no difference in the degree of anaerobic bacteria between the two suture materials.

Banche et al. 2007 [9]ClinicalHumanDentoalveolar surgerySilk (resorbable), nylon, polyester, and polyglecaprone 25A greater quantity of bacteria was found on nonresorbable sutures than on absorbable sutures. Absorbable silk and polyglecaprone 25 exhibited the smallest number of adherent bacteria.

Leknes et al. 2005 [10]ClinicalHumanPeriodontal surgerySilk and ePTFESilk sutures apparently cause a more extensive inflammatory tissue reaction compared to ePTFE sutures.

Leknes et al. 2005 [11]ExperimentalAnimal modelPeriodontal surgerySilk and ePTFESilk elicits more severe tissue reactions compared to ePTFE.

Otten et al. 2005 [12]ClinicalHumanDentoalveolar surgeryPolyglecaprone 25 and polyesterThe colonization rate of Streptococcus intermedius on both sutures was similar. Growth of Prevotella intermedia was faster on polyester as compared to polyglecaprone 25 suture material.

Vastardis and Yukna 2003 [4]ClinicalHumanPeriodontal surgeryPolyglactin 910A periodontal tissue reaction to the submerged sutures was concluded to be a possible cause of gingival abscesses in these patients.

Charbit et al. 1999 [13]ExperimentalAnimal modelPeriodontal surgerySilk, ePTFE, and PLA/PGAePTFE and the PLA/PGA sutures were superior to silk in terms of wound healing and inflammatory tissue reactions.

Selvig et al. 1998 [14] ExperimentalAnimal model Periodontal surgery Silk and chromic gut Bacterial invasion of the suture track was a common outcome regardless of the material used, but it was particularly prominent for silk sutures.

Abi Rached et al. 1992 [15]ClinicalHumanPeriodontal surgerySilk, nylon, polyester and perlonPolyester and perlon induced shorter and less intense tissue reactions compared to silk. Nylon caused the least inflammatory response, with earlier tissue repair.

Okamoto et al. 1990 [16]ExperimentalAnimal modelTooth extractionSilk, nylon, polyester, and cottonNylon showed the best biological results for healing of the dental socket and mucosa. Socket healing was delayed in models with silk and cotton sutures. Healing was only mildly delayed by polyester suture.

Castelli et al. 1978 [17]ExperimentalAnimal modelPeriodontal surgerySilk, nylon and cottonThe cheek mucosa reacted to the implantation of cotton and silk with aseptic inflammatory exudates. Nylon did not show an inflammatory response.

Lilly et al. 1972 [18]ExperimentalAnimal modelOral mucosal surgery (buccal mucosa and tongue)Silk, nylon, PGA, and chromicThe most intense tissue reactions were associated with braided silk sutures. Nylon, chromic, and PGA caused the least tissue inflammatory response.

Lilly et al. 1969 [5]ExperimentalAnimal modelOral mucosal surgery (cheek mucosa and tongue)Silk, nylon, surgical gut, chromic gut, steel, polyester, and linenSevere tissue reactions were induced by silk and polyester sutures whereas minimal or no tissue reaction was observed with nylon and polypropylene suture materials.

Lilly 1968 [19]ExperimentalAnimal modelOral mucosal surgery (cheek mucosa and tongue)Silk, nylon, surgical gut, chromic gut, steel, polyester, and linenThe most intense tissue reactions were induced by silk, cotton, and linen sutures whereas nylon, surgical gut, steel, and chromic showed a mild tissue response.

Lilly et al. 1968 [3]ExperimentalAnimal modelOral mucosal surgery (cheek mucosa and tongue)Silk, nylon, surgical gut, chromic gut, steel, polyester, cotton, dermal, and linenThe multifilament suture materials (silk, cotton, polyester, and linen) resulted in a significantly higher tissue reaction as compared to the monofilament (steel, nylon, surgical gut, and chromic gut) suture materials.

ePTFE: expanded polytetrafluoroethylene; PGA: polyglycolic acid suture; PLA: polylactic acid suture.