Evaluation and comparison of the efficacy of autologous fibrin glue with 4-0 silk sutures in periodontal flap closure and wound healing - A split mouth randomized controlled trial

J Biomater Appl. 2023 Sep;38(3):412-423. doi: 10.1177/08853282231191862. Epub 2023 Aug 10.

Abstract

Background: Fibrin glue has shown to be a pioneering remedy to overcome the inconvenience of suturing. Autologous products reduce the risk of contamination and immunological responses compared to commercial fibrin glue. Hence using autologous fibrin glue (AFG) as a tissue sealant in periodontal flap closure would be of added value for a predictable outcome.

Objective: To evaluate and compare the efficacy of AFG with 4-0 silk sutures in periodontal flap closure and healing.

Material and methods: Total of 17 patients diagnosed with generalized periodontitis in the age group of 18 to 60 years with probing pocket depth of ≥ 6 mm and clinical attachment level of ≥5 mm in at least two quadrants were categorized into test group (AFG) and control group (4-0 silk sutures). Primary outcome measures [modified gingival index (MGI), early wound index (EHI) and interleukin 1 beta (IL-1ß) and secondary outcome measures (oral hygiene index, plaque index and visual analog scale (VAS) were recorded at baseline, 1, 2, 3 and 4 weeks.

Results: A statistically significant reduction of IL-1ß value (p =.005); MGI (p = .02); EHI (p = .004), VAS scores (p < .001) and a positive Spearman's correlation (rho = 0.15) was seen between EHI scores & IL-1ß levels in test group at 1week period in comparison to control group.

Conclusion: AFG showed promising results as an alternative to sutures. The use of AFG significantly improved clinical parameters and reduced the levels of pro-inflammatory cytokines making it an effective adhesive with healing properties in the era of suture-less periodontal flap surgery.

Keywords: Autologous fibrin glue; interleukin 1 beta; periodontal flap closure; sutures; wound healing.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Fibrin Tissue Adhesive*
  • Humans
  • Middle Aged
  • Mouth
  • Silk
  • Sutures
  • Wound Healing*
  • Young Adult

Substances

  • Fibrin Tissue Adhesive
  • Silk