Types of Sutures Used in Dentistry
There are different types of sutures that are commonly used in various dental procedures to close incisions, wounds or surgical sites. The main types include:
- Absorbable sutures: Made from materials like catgut or polyglactin that are naturally absorbed by the body over time. Common examples include Vicryl and Polysorb.
- Non-absorbable sutures: Made from materials like silk, nylon or polypropylene that must be removed manually after about 5-14 days as the body does not absorb them. Popular options are silk and nylon.
-Monofilament sutures: Consist of single stranded fibers to minimize tissue drag and reduce infection risk. Vicryl rapide is an example.
-Multifilament sutures: Contain multiple fiber bundles that can pose a higher risk of infection. Silk is a common multifilament type.
Simple Interrupted Dental Sutures Technique
The simple interrupted suturing technique involves placing single Dental Suture separately along an incision with spaces between each suture knot. This is a commonly used method for closing dental incisions or extracting socket sites.
In this technique, the suture material such as Vicryl is threaded through a small curved needle. Starting from one end of the incision or wound, the threaded needle is used to pierce the tissues on both sides leaving about a 0.5cm margin and the suture ends are tied firmly in a square knot. This process is repeated at interval distances along the entire incision length.
The advantages of this method include more precise tissue approximation, decreased tension on wound edges and easy removal of individual sutures post-procedure if needed. However, it can be time-consuming to place multiple separated knots.
Continuous Dental Sutures
As the name suggests, continuous suturing involves placing a running/continuous suture stitch along the entire incision length without knots in between. This technique uses less suture material and can be faster than interrupted suturing.
To perform a continuous suture, the needle loaded with suture is passed through the tissues on one side of the incision from within out. It is then passed to the other side of the incision and passed back from outside in, just beside the first exit point.
This process is repeated along the entire incision, pulling the suture taut with each throw to approximate the wound edges tightly together. Only one knot is tied firmly at the end to secure the continuous suture in place.
While being faster, continuous suturing may lead to uneven tissue eversion or gaps between throws. It also needs to be removed as a single piece post-procedure.
Combination of Interrupted and Continuous Suturing
In some extensive surgical sites, a combination approach using aspects of both interrupted and continuous sutures can provide optimal wound apposition.
In this technique, interrupted sutures are first placed at intervals along corners and terminal ends of the incision to provide secure anchoring points. Continuous suturing throws are then placed in between to approximate the remaining tissue.
This blended method balances advantages of precision from interrupted knots and speed from continuous running stitches. It reinforces weaker areas like corners and ensures even eversion along the entire incision length.
Dental Sutures Knot Types in Dentistry
The type of knot used to secure suture strands is an important consideration. Common knot styles used in dental procedures include:
- Square Knot: Formed bypassing suture ends in opposite directions which produces a flat, visually appealing knot for tissue approximation. However, it can become untied easily.
-Surgeon's Knot: An improved version of square knot where a second throw is passed in opposite direction over the first. Provides greater knot security compared to square knot.
-Half Hitches Knot: Simple to place but prone to slippage. Often used just to hold suture ends temporarily before tying a more secure knot.
-Lasso or Slide Knot: Slipped along suture strands to desired tissue margin and tightened. Used for special circumstances like anchoring.
Proper dental sutures placement and knot techniques are critical skills for clinicians to achieve optimal post-op healing with minimum complications. Regular hands-on practice is recommended to refine suturing proficiency.
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