The 7 Suturing Techniques in Oral Surgery

Submitted By:
Elaine R. De Ocampo

Submitted To:
Patricia Dyan Ligon, DMD
 7 SUTURING TECHNIQUES
NAME INDICATIONS ADVANTAGES DISADVANTAGES
a) Single tooth a) Strong and can be used in a) Length of time required
1. SIMPLE extraction areas of stress. for placement
INTERRUPTED b) Multiple b) Degree of eversion b) It does not bring all
extractions produced. surfaces into contact
c) Third molar c) Placed 4-8 mm apart to and less supportive for
extraction close large wounds, so healing of the flap
d) Flaps that tension is shared. margins.
e) Biopsies d) Each is independent and c) Greater risk of
f) implants loosening one will not crosshatched marks (ie,
produce loosening of the train tracks) across the
other suture line
e) In secondary infection or d) Wound inversion if
hematoma, removal of suture is not placed
few sutures. correctly
f) Free of interferences
between each stitch and
easy to clean.
ORAL SURGERY by Fragiskos D. Fragiskos, DDS, PhD; © Springer-Verlag Berlin Heidelberg 2007
 7 SUTURING TECHNIQUES
NAME INDICATIONS ADVANTAGES DISADVANTAGES
a) Multiple extractions a) Simple and fast a) If cut at one point,
2. SIMPLE b) Bone graft b) Distributes tension suture slackens along
CONTINUOUS c) Removal of uniformly. the whole length of the
Mandibular tori c) More water tight wound, which will then
or RUNNING d) Tuberosity reduction closure. gape open.
e) And where esthetics d) Only 2 knots with
are not important. associated tags are
required
ORAL SURGERY by Fragiskos D. Fragiskos, DDS, PhD; © Springer-Verlag Berlin Heidelberg 2007
 7 SUTURING TECHNIQUES
NAME INDICATIONS ADVANTAGES DISADVANTAGES
a) Mostly used in long a) Because of the locking, a) Prevents adjustment of
3. CONTINUOUS edentulous areas, will be able to avoid tension over suture
LOCKING retromolar or multiple knots. line as tissue swelling
tuberosity areas. b) Single closing knot occurs
helps distribute the
tension uniformly
across the suture.
c) Watertight closure, so
cannot be used in
areas of tension.
d) Prevents excessive
tightening which might
lead to the tearing of
tissues
ORAL SURGERY by Fragiskos D. Fragiskos, DDS, PhD; © Springer-Verlag Berlin Heidelberg 2007
 7 SUTURING TECHNIQUES
NAME INDICATIONS ADVANTAGES DISADVANTAGES
a) Deep incisions a) Greater closure a) Scar formation
4. VERTICAL b) Where the wound strength b) Formation of edge
MATTRESS edges tend to evert b) Better distribution of necrosis
c) Where healing is wound tension c) Fine wound edge
expected to be c) Does not interfere approximation is
delayed for any with healing as suture difficult
reason, it is better to runs parallel to blood
give wound added supply
support by vertical d) For better adaptation
mattress. Used to and maximum tissue
control soft tissue approximation
hemorrhage.
 7 SUTURING TECHNIQUES
NAME INDICATIONS ADVANTAGES DISADVANTAGES
a) Wounds with large a) Will evert mucosal a) Constricts the blood
5. HORIZONTAL distances between margins, bringing supply to edges of
MATTRESS tissues greater areas of raw incision or the tissue
b) Implants tissue into contact. -So resulting in necrosis
c) Closure of extraction used for closing bony &/or dehiscence.
sockets deficiencies such as b) More trouble to insert
d) Used for closing bony oro-antral fistula or c) Difficult to remove
cystic cavities,
deficiencies such as
extraction socket
oro-antral fistula or
wounds
cystic cavities b) Prevents the flap from
e) Mostly used in cases being inverted into the
where intraoral bone cavity.
grafting is required, c) To control post-
involving volatile operative hemorrhage
closure with from gingiva around the
continuity. tooth socket to tense
the mucoperiosteum
over the underlying
bone.
 7 SUTURING TECHNIQUES
NAME INDICATIONS ADVANTAGES DISADVANTAGES
d) It does not cut
5. HORIZONTAL through the tissue, so
MATTRESS used in case of tissue
under tension
(inadequate tissue)
e) Good for hemostasis,
less prominent
scarring
ORAL SURGERY by Fragiskos D. Fragiskos, DDS, PhD; © Springer-Verlag Berlin Heidelberg 2007
 7 SUTURING TECHNIQUES
NAME INDICATIONS ADVANTAGES DISADVANTAGES
a) Extraction socket a) Rapid closure a) Due to its orientation,
6. FIGURE-OF-8 closure b) Provides a barrier to it is difficult to remove
b) Adaptation of gingival prevent clot b) Leaves a significant
papilla around the displacement amount of suture
tooth threads inside the
c) Bone graft placement socket.
in socket
 7 SUTURING TECHNIQUES
NAME INDICATIONS ADVANTAGES DISADVANTAGES
 Simple,  Allow suture to remain  Technically more
7. SUBCUTICULAR uncomplicated for a longer period of difficult to master
wounds time without  Doesn’t hold in thin
development of skin
crosshatch scaring.
 Excellent cosmetic
closure
 No stitch to remove
REFERENCES:
https://www.dentalbooks.bg/PDF/suturing_techniques.pdf

https://gmdgroup.com.tr/en/suturing-techniques/

https://www.juniordentist.com/suturing-techniques-used-in-dentistry.html

Hassan H K. Dental Suturing Materials and Techniques. Glob J Oto 2017; 12(2): 555833. DOI:
10.19080/GJO.2017.12.555833

https://www.slideshare.net/alaniudm/suturing-techniques-involved-in-dental-surgery

https://www.slideshare.net/AkshatSachdeva/suturing-materials-and-techniques

Oral Surgery by Fragiskos D. Fragiskos, DDS, PhD; © Springer-Verlag Berlin Heidelberg 2007
Chapter 3.7.1 Suturing Techniques by F. D. Fragiskos, pgs.39-41