AutoresAlexander De Greef, Kato Van Caesbroeck, Hanne Langers, Amy Vanrusselt, Pierre Lahoud, Ana Boquete‐Castro, Andy Temmerman
Una investigación in vitro ha examinado la influencia del diámetro y el material de las suturas en la resistencia al desgarro de los tejidos blandos orales, un aspecto crucial en la cirugía plástica periodontal. El estudio comparó diferentes grosores y materiales de sutura en especímenes de encía y mucosa, registrando la fuerza máxima de ruptura y el modo de fallo. Los hallazgos sugieren que los hilos más finos actúan como protectores, previniendo el desgarro tisular, y que ciertos materiales ofrecen mayor seguridad. La selección adecuada de la sutura, basada en estas propiedades biomecánicas, puede optimizar la técnica de sutura atraumática y mejorar los resultados en procedimientos periodontales y de cirugía plástica oral, salvaguardando la integridad de los tejidos delicados.
AIM: To assess how suture diameter, material composition and tissue characteristics influence the tension-to-tearing behaviour of oral soft tissues, with the objective of optimising atraumatic suturing. MATERIALS AND METHODS: This in vitro cadaver study evaluated 288 standardised porcine oral soft-tissue specimens (144 gingiva, 144 lining mucosa). Twelve different suture types including four distinct diameters (4-0, 5-0, 6-0, 7-0) and three different materials (polyvinylidene fluoride [PVF], polyamide [PA] and polyglycolic acid [PGA]) were tested using a calibrated Instron microtester. Maximum rupture force (N), failure mode and tissue thickness (mm) were recorded. Statistical analysis relied on three-way ANOVA, Tukey's post hoc testing and Pearson's correlation (α = 0.05). RESULTS: The overall mean maximum rupture force was 5.03 ± 3.00 N. Rupture force increased with suture diameter (p = 0.0001) and differed between materials (p < 0.0001; PGA ≈ PVF > PA). Gingival specimens resisted higher loads than mucosal specimens (p = 0.003). Fine sutures (6-0, 7-0) failed mainly by thread rupture, while thicker sutures (4-0, 5-0) caused tissue tearing, supporting the concept of a mechanical safety buffer. PA (6-0) generally preserved tissue integrity, whereas PVF and PGA required 7-0 in delicate mucosa to ensure comparable tissue protection. Tissue thickness correlated positively with rupture force (r = 0.49, p < 0.001). CONCLUSIONS: Finer sutures (6-0 and 7-0) function as protective mechanical fuses, safeguarding delicate tissues during manipulation. PA 6-0 provides reliable protection, while 7-0 PVF and PGA are recommended for fragile mucosa manipulation. These findings provide a biomechanical framework for evidence-based suture selection in periodontal plastic surgery.
Greef AD, Caesbroeck KV, Langers H, Vanrusselt A, Lahoud P, Boquete‐Castro A, et al. Effect of Suture Diameter and Material on Oral Soft‐Tissue Tearing Behaviour: An In Vitro Study Relevant to Periodontal Plastic Surgery. Journal Of Clinical Periodontology. 2026. doi:10.1111/jcpe.70127
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