COMPARATIVE EVALUATION OF HEALING AFTER USING N-BUTYL CYANOACRYLATE (TISSUE ADHESIVE) OR SILK SUTURE ON PERIODONTAL FLAP CLOSURE- A CLINICAL STUDY
Main Article Content
Keywords
Cyanoacrylates, Flap surgery, Silk sutures, Tissue adhesives
Abstract
The aim of this study to compare and evaluate the healing after using N-butyl cyanoacrylate (tissue adhesive) or silk suture on periodontal flap closure.
Material and methods: The randomized clinical trial was conducted in Department of Periodontics at Vananchal Dental College and Hospital, Garhwa, Jharkhand, India from January 2021 to January 2022. 50 healthy patients who fulfilled the inclusion and exclusion criteria and were included in this study. Plaque Index (PI), Gingival Index (GI), Wound healing Index (WHI), Histological Assessment (HA)all the study parameters were included in the present study.
Results: At baseline postoperative in the suture sites, the mean plaque score was 0.736±0.165 which was reduced to 0.741±0.0997at a 42-day interval. In the cyanoacrylate sites, the mean plaque score at the baseline recall visit was 0.767±0.1697 and at the 42-day interval, it was 0.738±0.094. The mean gingival index in the suture sites at the baseline and42 days interval was 10.688±0.0745 Vs 0.675±0.087 respectively. In the cyanoacrylate sites, it was 0.6785±0.0744 at the baseline day and 0.675±0.069 at the 42 days follow-up. Wound Healing index score observed at cyanoacrylate sites was also lesser as compared to suture sites with statistical significance at 7th day indicating that wound healing was better when flaps were closed with cyanoacrylate as compared to silk sutures. There was no statistical significance observed between the epithelium of cyanoacrylate and suture sites on 7th and 42nd day. Inflammatory cells at cyanoacrylate sites were lesser as compared to suture sites with statistical significance on the 7th day. Vascularity at cyanoacrylate sites was lesser as compared to suture sites with statistical significance on the 7th day.
Conclusion:The closure of periodontal flaps with cyanoacrylate results in better initial post-operative healing as compared to closure with silk suture and that this method of closure can be advocated in a routine surgical periodontal practice
References
2. Hollander JE, Singer AJ, Valentine S, et al: Wound registry: Development and validation. Ann Emerg Med.1995; 25:675.
3. Banche G, Mandras N, Gallesio C, et al: Microbial adherence on various intraoral suture materials in patients undergoing dental surgery. J Oral Maxillofac Surg.2007;65:1503.
4. Carranza F.A. General principles of periodontal surgery. In Newman M.G., Takei H.H., Klokkevold P.R., Carranza F.A. Clinical Periodontology. W.B. Saunders and Company, 10th Edn. 2007:887-901.
5. Levin M.P. Periodontal suture materials and surgical dressings. Dent Clin of North Am 1980; 24:767-781.
6. Coover HWJr, Toyner FP, Shearer NHJr, et al. Chemistry and performance of cyanoacrylate tissue adhesives. Soc Plastic Engineers J 1959;15:413.
7. Binnie WH, Forrest JO. A study of tissue response to cyanoacrylate adhesive in periodontal surgery. J Periodontol 1974;45(8):619–625. DOI: 10.1902/jop.1974.45.8.2.619.
8. DeRenzis FA, Aleo JJ. An in vitro bioassay of cyanoacrylate cytotoxicity. Oral Surg, Oral Med, Oral Pathol 1970;30(6):803–808. DOI: 10.1016/0030-4220(70)90344-0.
9. Soni R, Narula A, Kumar M, et al. Comparing cyanoacrylate tissue adhesive and conventional subcuticular skin sutures for maxillofacial incisions—a prospective randomized trial considering closure time, wound morbidity, and cosmetic outcome. J Oral Maxillofac Surg. 2013;71(12):2152.e1–2152.e8. DOI: 10.1016/j.joms.2013.08.029.
10. Perez M, Fernandez I, Marquez D, et al. Use of N-butyl-2- cyanoacrylate in oral surgery: biological and clinicalevaluationArtific Organs 2000;24(3):241–243. DOI: 10.1046/j.1525-1594.2000. 06519.x.
11. Nevins M, Mendoza-Azpur G, Angelis ND, et al. The biocompatibility of cyanoacrylate tissue adhesive inconjunction with a collagen membrane for providing soft andhard tissue regeneration in extraction socket preservation procedures. Int J PeriodontRestorat Dentis 2018;38:s37–s42. DOI: 10.11607/prd.3770.
12. Gumus P, Buduneli E. Graft stabilization with cyanoacrylatedecreases shrinkage of free gingival grafts. Australian Dent J 2014;59(1):57–64. DOI: 10.1111/adj.12149.
13. Silness J, Löe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964;22:121-35.
14. Löe H. The gingival index, the plaque index and the retention index systems. J Periodontol. 1967;38:610-6.
15. Huang LH, Neiva RE, Soehren SE, Giannobile WV, Wang HL. Effect of platelet rich plasma on the coronally advanced flap root coverage procedure: A pilot human trial. J Periodontol. 2005:1768-77.
16. Kulkarni SS, Chava VK. Comparison of cyanoacrylate and silk sutures on healing of oral wounds--an animal model study. Indian J Dent Res 2003;14(4):254–258.
17. 23. Borie E, Rosas E, Kuramochi G, et al. Oral applications of cyanoacrylate adhesives: a literature review. Bio Med Res Int 2019. 1–5.
18. Giray CB, Sungur A, Atasever A, Araz K. Comparision of silk sutures and n-butyl-2-cyanoacrylate on healing of skin wounds. A pilot study. Aust Dent J. 1995;40:40-3.
19. Macht SD, Krizek TJ. Sutures and suturing: Current concepts. J Oral Surg. 1978;36:710-3
20. Kulkarni S, Dodwad V, Chava V. Healing of periodontal flaps when closed with silk sutures and n- butyl cyanoacrylate: A clinical and histological study. Indian J Dent Res. 2007;18:72-7
21. Greer RO Jr. Studies concerning the histotoxicity of isobutyl-2- cyanoacrylate tissue adhesive when employed as an oral hemostat. Oral Surg Oral Med Oral Pathol. 1975;40:659-69
22. Bhasker SN, Frisch J. Use of cyanoacrylate adhesives in dentistry. J Am Dent Assoc. 1968;77:831-7.
23. Javelet J. Torabinejad M, Danforth R. Isobutyl cyanoacrylate: A clinical comparison with sutures in closing mucosal incisions in monkeys. Oral Surg Oral Med Oral Pathol. 1985;59:91-4

