How to close intraoral wounds and incisions
Best practices for choosing dental sutures, needles and suturing methods
May 01, 2011
You're staring at a 5-mm hole left after extracting a dog's lower second premolar. Which suture, needle and knot do you choose? A similar packet to what you used on that ovariohysterectomy you performed earlier in the day? Actually, that would be a poor choice.
The objective of dental suturing is to close surgical defects and promote first intention healing without traction of the soft tissue. You'll want suture material that has little tissue reaction and is easy to handle, strong enough to hold the tissues together and attached to a strong needle that stays sharp and stable in the needle holder. When used properly, surgical sutures should hold the gingiva or flap edges in apposition until the wound has healed enough to withstand normal functional stresses, thus improving patient comfort.
Suture materialsSuture material is classified as natural or synthetic; absorbable or nonabsorbable; monofilament or multifilament. A suture should:
It's important to select the specific suture thread and diameter based on the thickness and general health of the tissues to be sutured.
For intraoral surgery, absorbable suture that will lose its tensile strength at about the same rate the tissue gains strength is generally chosen. Normally, wound healing takes place in 14 to 21 days, with variation based on blood supply, patient age, nutritional status, presence of infection or systemic disease and corticosteroid use. Suture options include:
• Synthetic, absorbable suture materials, which deliver minimal tissue reaction, loss of tensile strength and increased absorption times that provide adequate time for oral incisions to heal. They're hydrophobic—primarily broken down through the process of hydrolysis with only a mild tissue reaction. Exposure to oral infections and digestive enzymes doesn't markedly affect the absorption rate.