* Dr . Monica G Subramanian ** Dr . Sonia Sharma *** Dr . Manjit Singh Mani Biir
The Journal
A case study comparing the efficacy of Fibrin Glue and Black Silk Suture
Suturing of incision part is the important step in the periodontal surgical procedure . Black silk sutures are most frequently used materials which is considered as gold standard for wound closure in periodontal surgical procedure . The fibrin sealant provides tissue fixation without any injury , this property is essential for fixing flaps , even in microsurgical procedures and it also enhances early wound healing and stimulate repair . Thus , fibrin sealantsform a better substitute and an effective means for fixing tissues after periodontal surgery .
Introduction
Periodontitis is the infectious disease affecting the supporting structure of the teeth . 1It is caused by specific group of micro-organisms which colonize the tooth surface in the form of a biofilm which may lead to inflammation , loss of
2,3
attachment and bone loss . The ultimate goal of periodontal therapy is to stop and reverse the loss of periodontal attachment resulting from periodontal diseases and regenerate periodontal tissue and promote early wound
4,5
healing . To facilitate this several materials have been used to aid in periodontal surgical procedures which promote early wound healing
. 6,7 and augment tissue regeneration
Closing of surgical incision is an important step in the surgical procedure . The various materials for wound closure are sutures , skin clip or staples , skin tapes , and wound adhesive ( autologous fibrin glue , fibrin -fibronectin sealing system ( tissuecol ), cyanoacrylate
8,9
, mussel adhesive protein ). Amongst these , black silk sutures are most often used materials in the day- to-day surgical procedures . However theydemand more time and effort from the surgeon and there is a need to substitute these materials with user friendly and
successful wound closing materials such as
10 fibrin glue .
Fibrin-sealing system is a quite effective means to fix tissues after periodontal tissue surgery , being much easier and quicker than conventional sutures . Moreover , sutures tend to cause a mild inflammatory reaction around them , whereas fibrin glue enhances early
11
wound healing . In periodontal plastic surgeries of esthetically important areas it gives better
11 results than sutures . Case Report
A conventional flap surgery was carried out in the mandible anterior region extending from buccodistal region of left mandibular canine till buccodistal region of rightmandibular canine (# 31,32,33,41,42,43 ) of male patient aged 46 years old who reported to the Department of Periodontics and Oral Implantology of Maharaja Ganga Singh Dental College and Research Center . The patient was given silk sutures on mandibular left anterior region (# 31,32,33 ) and fibrin glue was applied on the right mandibular region (# 41,42,43 ).
After the surgery was carried out , the flap was re-positioned to its original place . Fibrin glue didn ’ t necessitate any special skill to perform . The same was injected in the involved area using simply a syringe . The glue rapidlyadhered to tissues and amount of fibrin glue required to fix tissues , averaged less than 0.1-0.2ml per tooth ( buccal aspect ). Shortly after the
* Post Graduate Student
** Post Graduate Student
*** Professor & Head , Dept of Periodontology and Oral Implantology , Maharaja Ganga Singh Dental College & Research Centre , Sriganganagar , Rajasthan
26 Vol . 13 No . 3 Sep-Dec 2017