A clinico-histological comparative evaluation of healing of periodontal flaps when approximated with silk sutures and n-butyl cyanoacrylate

Abstract

Periodontitis is an inflammatory disease which results by the interaction between bacteria leading to inflammation and destruction of the connective tissue attachment apparatus. Flap surgeries are most frequently employed treatment modality for deep periodontal pockets. Over the decades, many suture materials like silk and nylonare being used for the approximation of the flaps. In the present scenario of periodontal advancements, fibrin glue manifests to be a great alternative to flap approximation with better clinical and histological results.This randomized clinico-histological study aims to compare the healing of modified flap operation when approximated with Silk suture and N-butyl cyanoacrylate bioadhesive.Thirty patients were recruited in this clinico-histological study. In Group A, surgical site was approximated by 3-0 black braided silk sutures (@TRUSILK) and in Group B, N-butyl cyanoacrylate bioadhesive (@EPICLOS) was used by driplets for flap approximation. Patients were recalled for removal of sutures and any cyanoacrylate present after 1 week of surgery. All the parameters (clinical and histological) were taken at baseline and at 7 day.On intra and inter group comparison all the clinical parameters i.e., Gingival index (GI), Papillary Marginal Attachment (PMA) Index, Turesky-Gilmore-Glickman modification of Quigley Hein Plaque Index (TQHPI), Wound healing index (WHI) and histological parameters i.e., inflammatory cells and vascularity shows significant reduction at 7 day in group B (N-butyl-cyanoacrylate).N-butyl-cyanoacrylate (Group B) is more effective in reducing the clinical and histological parameters than Silk sutures (Group A).