Bone anchoring of sutures for adequate repositioning of the soft tissue flaps in one stage dental implants

Abstract

The choice of suture material and technique is important to optimize wound healing. If surgical wound edges are not properly approximated healing may be delayed because blood may accumulate under the flap and separate it from the underlying bone. The authors present an alternative suturing technique. They use a ‘C suture’ to fix and minimize mobilization of the soft tissues around non-submerged implants.

Suture materials and suturing techniques should be choosen according to the surgical procedure and their needs. Choice of suture material and technique is important to optimize wound healing. Accurate apposition of the surgical flaps enables haemostasis, reduces the wound size to be repaired, prevents unnecessary bone destruction and improves patient comfort. If surgical wound edges are not properly approximated and dead spaces are present blood may accumulate under the flap and delay the healing process by separating the flap from the underlying bone. The authors present an alternative technique that uses a ‘C suture’ to fix and minimize mobilization of the soft tissues around non-submerged implants.

The surgical technique included the standard placement of the implants in prepared slots following the removal of full thickness flap. After insertion of the dental implant, two holes, one proximal to the implant and one distal to it, about 2 mm away from the thread of the implant were prepared by a small round bur ( Fig. 1 ). Two sutures (4.0 vicryl), one distal and one mesial to the implant, passing through the prepared bone holes and neck of the implant in C style were tied to force the soft tissues through the implant ( Fig. 2 ). The flaps were closed by simple interrupted sutures ( Fig. 3 ). 0.12% chlorexidine gluconate mouth rinse (2 times daily) and amoxicillin 500 mg (3 times daily) were prescribed. One week later sutures were removed. The patient was scheduled for an appointment at the second postoperative month ( Fig. 4 ).

Fig. 1
Two holes, one proximal one distal to the implant and about 2 mm away from the thread of the implant were prepared.

Jan 24, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Bone anchoring of sutures for adequate repositioning of the soft tissue flaps in one stage dental implants

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