Comparative Evaluation of Cyanoacrylate Bioadhesive Material and Silk Sutures on Healing of Periodontal Flaps: A Systematic Review and Meta-Analysis

Abstract

Background: Close post-operative adaptation of the periodontal flap onto the prepared root surface and the maintenance of this adaptation for a period is critical to the reestablishment of a healthy dentogingival unit. Applications of sutures require passage of a foreign material through tissue which elevates tissue reactivity. It also provides a pathway for the retention of microorganism onto the tissue which leads to further infection. So, in order to overcome the existing drawback with sutures, cyanoacrylate which is a biocompatible tissue adhesive can be used for the closure of the incised wounds. Hence, the current review aimed to assess the effectiveness of cyanoacrylate bioadhesive material in healing of periodontal flaps as compared to the conventional silk sutures.
Materials and Methods: A systematic literature search was conducted in three databases: ProQuest, Google Scholar and PUBMED and a hand search of relevant scientific journals was performed for Randomized controlled trials. Studies were assessed for quality with the help of predetermined criteria which categorized the studies into high, medium and low quality. Random effect models were used for performing meta-analysis for Gingival index, Plaque index, VAS pain score, Wound healing index, Fibrosis, Vascularity and Inflammatory cells on the 7th day post-operative.
Results: From 1101 initial studies, 14 were eligible for full text review, with 8 RCTs included in the meta analysis. The analysis favored cyanoacrylate bioadhesive material over silk sutures for the closure of periodontal flap with statistically significant improvement seen for Fibrosis, Inflammatory cells, Vascularity, Plaque index and Gingival index.
Conclusion: Within the limitations of this review, the use of Cyanoacrylate bioadhesive material proved to be beneficial in improving the clinical and histological parameters when compared to Conventional silk sutures technique for the closure of Periodontal flap after surgery.