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ePaper created 2016-01-07, 12:59:38 | version 1.38.0
research I eign-body response. The use of sutures, for example, doesnotdirectlycauseinfection,butmaypromotethe developmentthereof.OftenIamaskedwhattypeofsu- ture I prefer: it is a question that I definitely do not like because it assumes that you have only one type of pa- tient,onlyonetypeofsurgeryandonlyonetypeofsit- uation.Thesurgeonmustassesseachcaseindividually andselectthematerialthatcanbestpromotehealingby reducing the risk of infection. The main purpose of the suture must obviously be to achieve a first intention woundhealing,astoppriority.Togetasecondintention healing is always a failure, which involves serious like- lihoodofdehiscenceofthewoundandhighprobability of failure. For this reason, both the knowledge of ade- quatesuturingandknottingtechniques(atopicthatis so extensive that we cannot conver it in this work) and theselectionofthemostsuitablesuturematerialareof fundamental importance. There are different types of suturethreads,whichforthesakeofsimplicityaresum- marisedinthefollowingtable.Suturescanbeclassified Tab. 2_Types of sutures for different clinical indications. Fig. 6_Apicectomy and application of biomaterial. Fig. 7_A monofilament suture. Fig. 8_A post-extraction monofilament suture. Fig. 9_Excellent healing of tissue in only six days after extraction. I 11implants4_2015 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Natural sutures Indications Non-absorbable silk suture Extractive surgery with low risk of superinfection Synthetic sutures Absorbable multifilament coated suture (e.g.VICRYL,Ethicon) In all specialties in which the sutures used cannot be removed (e.g.mucogingival surgery Monofilament absorbable suture (e.g.MONOCRYL,Ethicon) Gingival surgery; very useful to use as continuous suture Non-absorbable multifilament coated suture (e.g.ETHIBOND EXCEL,Ethicon) It replaces silk in complex cases of extractive surgery (e.g.regenerative surgery); maintenance of haemostatic products on the sites of extraction Non-absorbable monofilament suture (e.g.PROLENE,Ethicon) Ideal for continuous sutures,elongation of clinical crown, apicectomy