Having learned to sew at a young age, I remember endless cross-eyed attempts to thread needles, and then poking them through the material and straight into my finger countless times. I never thought about how tricky suturing delicate oral tissues must be. The dental articles I’ve read over the years didn’t really go into the physical suturing process. Now I understand that stitching up an incision requires specialized equipment and quite a bit of skill for proper, atraumatic wound healing. The inventions of the pre-threaded curved needle and absorbable suture materials must have seemed like miracles, especially when they resulted in even less tissue trauma and healing time for patients.
Considerations for choosing suture materials
Suture materials are categorized by diameter, resorption rate, and material. They are available in natural (connective tissue from either the serosal layer of beef or the submucosal fibrous layer of sheep intestines) or synthetic materials. Considerations include: type of procedure and tissue, coated versus uncoated (which affects soft-tissue drag), prevention of bacterial wicking into surgical sites, rate of absorption, how long tensile strength is maintained, composition (monofilament or multifilament; braided versus twisted), and dyed or undyed.
Considerations for choosing needles
Suture needles come in many shapes and sizes. I’ve learned that they are curved to enable making tiny stitches in tight, hard-to-reach spaces, and can have either tapered tips (much like my sewing needles) or triangular tips that easily slice through tissue. Needles must be strong yet malleable. They must be sharp, to decrease tissue damage and the force necessary to penetrate oral tissues. They are available in various curve and pre-threaded configurations, as well as conventional and reverse cutting. Like sutures, some are coated to make them smoother and reduce tissue drag.
Visit the Dental Product Shopper category pages to read more about of absorbable suture/needle combinations or to research certain products.