Best type of suture for implant surgery?

For standard implant cases 4-0 chromic gut, high esthetic anterior case Teflon. Over sewing a difficult flap 3-0, 4-0 BSS. Personally I hate using Vicryl, difficult to work with and hangs around a long time always needs to be removed. Never use nylon in the mouth it hurts. I would like some imput on the dyed PGA not much experience with this. My suture choice is about how long I need it to be around and what I am trying to accomplish with the surgical site and whether or not I can trust the patient, also what's on sale!

I like vicryl on posterior cases and Prolene in the esthetic zone as nice tissue response and scar reduction but only 5.0 as even 4.9 will irritate the patient ... Not worried about slow resorption of vicryl as like to see all patients as follow up anyway

The most important consideration is that you want a monofilament suture, not braided as silk. I find that PTFE sutures tend not to hold a knot properly..... they slip, but I do use them in combination with fine gut...so between the two of them, I am assured of tension free closure and an incision that stays closed.......ahem; most of the time.

Some discussion on needle too. Type, size, etc.

why not use silk? Ties very well and very easy to remove. It may accum more debris but pt needs good after care and i remove them 2 weeks post op anyway.

Use silk sutures. Usually remove them after 10days. Find them satisfactory

The Salvin PGA Surgi Point come in 7-14 day and 21-28 day resorb periods. Although braided, they seem kind to tissue and the loose ends are soft and floppy - no irritation. They come in handy on multiple layer graft sites, esp for anchoring submerged connective tissue. Although they slide easily thru tissue, it's easy to tie a tight knot on a loose loop since, unlike gut, poly and silk, each line seems to bind and hold together on the first leg of the knot. Similar to Vicryl, but much less expensive and higher strength per diameter.

I use to use 4.0 PTFE normally and 6.0 nylon, no more silk as it wicks in bacteria, agreed they are cheap, work and have a long history. Recently switched to Glycolon 4.0 for apical mattress and 5.0 for interrupted sutures. Dyed violet and last three weeks. Still use Vicryl, till they are gone, difficult to tie and stink rather rapidly and has many said previously, end up taking them out because of complaints from patients. Resorba Glycolon from Germany PB41421 and PB41420 PGA-PCL

I love PTFE I find it easy to use I like the Cytoplast brand from Osteogenics only complaint is the size (cant get smaller than 4.0) and the needle size

The best type of suture for implant surgery is..experience:)(just kidding)..It is the one you are familiar with,because there are a lot of materials and sizes etc.,and the prices for them varies.The 3.0 silk reverse cutting is probably the most used in implant surgery.And art and technique in implant dentistry only requires expensive sutures for the untalented amongst us:)winkwink

If comment guidelines require one to "be respectful" I am surprised that OsseoNews allowed the juvenile remarks of the previous commenter. Perhaps this doctor should stick to a site where he is probably affiliated with more of his peers, such as Weekly Reader. :)winkwink

My suggestion is combining 5-0 and 6-0 PVDF monofilament sutures, using a round needle with a trocar point. This suture size might help in flap tension assessment. Pay attention not to have loose knots due to material rigidity.

In my opinion ( and that may sound controversial) the choice of suture material makes no difference in regards implant procedure success. We all have our preferences for different reasons and obviously use a suture material that works in our hands. I personally don't like silk for the reasons mentioned above but I know it works. Some of us choose a material based on price and ease of handling. That is totally ok as long as the results are good. I personally use gut (4/0 and 5/0) wherever possible. When I handle delicate tissue around an implant in the esthetic zone I'll use polymer sutures (6/0, 7/0). If substantial grafting was done and I'm concerned with swelling and wound opening, I'll use Gortex sutures and reinforce with a continuous interlocking gut. Suturing technique makes a very big difference in my opinion (but not so much the material). I'm happy to answer more questions. USC suturing course will clarify this issue and will focus on suturing techniques. It's good to experiment with different types of sutures and materials and develop a preference (coming this June 20, 2015)

Never had a problem with 5-0 silk, chlorhexidine, and removal in 4-5 days. Sooner removed=better healing. Clinical judgment required.