Abstract
Background: Suture materials employed in oral surgery vary with respect to their structure, absorbability, coating, handling characteristics, and propensity for plaque retention and tissue reaction. These attributes may impact early wound stability and signs of postoperative inflammation.
Objective: To compare four widely utilized oral surgery suture materials with respect to clinician-rated intraoperative performance and early postoperative clinical response.
Methods: A total of forty patients requiring oral surgical procedures involving suturing were incorporated into a four-arm pilot comparative study. Four types of suture materials were assessed: absorbable monofilament Monocryl 4-0, non-absorbable braided polyester Ethibond Excel 4-0, absorbable antibacterial-coated braided polyglactin 910 Vicryl Plus 4-0, and braided silk 4-0. Follow-up evaluations were conducted at days 3, 7, and 14. Sutures were removed on day 7, including those that are absorbable. The operator rated smoothness, handling, and resistance during placement on a 0-10 scale. Clinical scores for edema, gingival inflammation, perilesional plaque, and suppuration were documented at follow-up.
Results: Monocryl demonstrated the highest mean smoothness score (8.47 ± 0.85) and clinician-rated resistance score (8.92 ± 0.74). Silk exhibited the lowest scores in smoothness (5.60 ± 1.10) and resistance (5.21 ± 0.97), while attaining the highest handling score (7.82 ± 0.95). Early clinical assessments indicated increased edema and inflammation associated with silk at 3 days; conversely, Vicryl Plus showed comparatively low inflammatory scores and low perilesional plaque scores at day 3 and lower scores than silk during follow-up.
Suppuration was infrequent across all groups.
Conclusions: Within the limitations of this pilot dataset, synthetic sutures appeared to provide more favorable intraoperative performance than braided silk, while antibacterial-coated Vicryl Plus showed favorable early clinical scores. The findings should be interpreted cautiously because of the small sample size, incomplete reporting of allocation and ethics procedures, unclear scoring definitions, and absence of microbiological analysis. Larger randomized clinical studies with standardized clinical and microbiological outcomes are required before definitive recommendations can be made.
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Copyright (c) 2026 Tommaso Pizzolante, Gianluca Botticelli, Jasmin Gholami Noudeh, Alessia Bianchi, Domenico Marcattili, Elisa Sorrentino, Eugenio Ortale, Sofia Rastelli, Stefano Mummolo