Bacterial Colonization on Different Suture Materials Used in Oral Implantology: A Randomized Clinical Trial
Abstract
Objectives: This study aimed to compare the colonization of Enterococcus faecalis (E. faecalis), Escherichia coli (E. coli), Streptococcus mutans (S. mutans) and Staphylococcus aureus (S. aureus) isolated from the oral cavity on different suture materials used in oral implantology.
Materials and Methods: Patients scheduled for implant surgery were included in this study. After flap approximation, the surgical site was sutured using silk, nylon, polyglactin 910 (Vicryl®) and triclosan-coated polyglactin 910 (Vicryl® Plus) sutures in a randomized order. Seven days after surgery, the sutures were removed and incubated in bile esculin agar (for E. faecalis), MacConkey agar (for E. coli), mitis salivarius agar (for S. mutans), and mannitol salt agar (for S. aureus) at 37°C for 24 h. The colonies were then counted. Data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests.
Results: Vicryl® sutures showed the highest accumulation of E. faecalis, followed by Vicryl® Plus, nylon, and silk. There was no significant difference between nylon and silk (P=0.5) or between Vicryl® and Vicryl® Plus (P=0.4). Vicryl® Plus sutures showed the highest accumulation of E. coli followed by Vicryl®, silk and nylon (P<0.01). Vicryl® sutures showed the highest accumulation of S. mutans, followed by Vicryl® Plus, silk, and nylon. Vicryl® Plus sutures showed the highest accumulation of S. aureus, followed by Vicryl®, nylon, and silk.
Conclusion: Nylon sutures showed the least microbial accumulation. Vicryl® and triclosan-coated Vicryl® Plus sutures had no advantage over the commonly used silk sutures in decreasing the number of bacteria.
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2. Jager DHJ, Maarse F, Klausch T, Karagozoglu KH, Ten Bruggenkate CM, Sandor GK, et al. Wound dehiscences following pre-implant bone augmentation with autogenous iliac crest bone grafts: A retrospective cohort study. Int J Oral Implantol (New Malden). 2019 Jan;12(2):227-36.
3. Otten JE, Wiedmann-Al-Ahmad M, Jahnke H, Pelz K. Bacterial colonization on different suture materials--a potential risk for intraoral dentoalveolar surgery. J Biomed Mater Res B Appl Biomater. 2005 Jul;74(1):627-35.
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5. Tabrizi R, Mohajerani H, Bozorgmehr F. Polyglactin 910 suture compared with polyglactin 910 coated with triclosan in dental implant surgery: randomized clinical trial. Int J Oral Maxillofac Surg. 2019 Oct;48(10):1367-71.
6. Dhom J, Bloes DA, Peschel A, Hofmann UK. Bacterial adhesion to suture material in a contaminated wound model: Comparison of monofilament, braided, and barbed sutures. J Orthop Res. 2017 Apr;35(4):925-33.
7. Lafaurie GI, Sabogal MA, Castillo DM, Rincon MV, Gomez LA, Lesmes YA, et al. Microbiome and Microbial Biofilm Profiles of Peri-Implantitis: A Systematic Review. J Periodontol. 2017 Oct;88(10):1066-89.
8. Rakic M, Grusovin MG, Canullo L. The microbiologic profile associated with peri-implantitis in humans: A systematic review. Int J Oral Maxillofac Implants. 2016 Mar;31(2):359-68.
9. Albertini M, Lopez-Cerero L, O'Sullivan MG, Chereguini CF, Ballesta S, Rios V, et al. Assessment of periodontal and opportunistic flora in patients with peri-implantitis. Clin Oral Implants Res. 2015 Aug;26(8):937-41.
10. Zhuang LF, Watt RM, Mattheos N, Si MS, Lai HC, Lang NP. Periodontal and peri-implant microbiota in patients with healthy and inflamed periodontal and peri-implant tissues. Clin Oral Implants Res. 2016 Jan;27(1):13-21.
11. Canullo L, Rossetti PH, Penarrocha D. Identification of Enterococcus faecalis and Pseudomonas aeruginosa on and in implants in individuals with peri-implant disease: A cross-sectional study. Int J Oral Maxillofac Implants. 2015 May;30(3):583-7.
12. Narendrakumar K, Kulkarni M, Addison O, Mazare A, Junkar I, Schmuki P, et al. Adherence of oral streptococci to nanostructured titanium surfaces. Dent Mater. 2015 Dec;31(12):1460-8.
13. Meza-Siccha AS, Aguilar-Luis MA, Silva-Caso W, Mazulis F, Barragan-Salazar C, Del Valle-Mendoza J. In Vitro evaluation of bacterial adhesion and bacterial viability of Streptococcus mutans, Streptococcus sanguinis, and Porphyromonas gingivalis on the abutment surface of titanium and zirconium dental implants. Int J Dent. 2019 Jun;2019:4292976.
14. Obermeier A, Schneider J, Harrasser N, Tubel J, Muhlhofer H, Pforringer D, et al. Viable adhered Staphylococcus aureus highly reduced on novel antimicrobial sutures using chlorhexidine and octenidine to avoid surgical site infection (SSI). PLoS One. 2018 Jan;13(1):e0190912.
15. Yang Y, Yang SB, Wang YG, Zhang SH, Yu ZF, Tang TT. Bacterial inhibition potential of quaternised chitosan-coated VICRYL absorbable suture: An in vitro and in vivo study. J Orthop Translat. 2017 Jan;8:49-61.
16. Fowler JR, Perkins TA, Buttaro BA, Truant AL. Bacteria adhere less to barbed monofilament than braided sutures in a contaminated wound model. Clin Orthop Relat Res. 2013 Feb;471(2):665-71.
17. Brandt MT, Jenkins WS. Suturing principles for the dentoalveolar surgeon. Dent Clin North Am. 2012 Jan;56(1):281-303.
18. Balamurugan R, Mohamed M, Pandey V, Katikaneni HK, Kumar KR. Clinical and histological comparison of polyglycolic acid suture with black silk suture after minor oral surgical procedure. J Contemp Dent Pract. 2012 Jul;13(4):521-7.
19. Zhang Q, Zhang C, Fang X, Luo X, Guo J. Biomaterial suture Vicryl Plus reduces wound-related complications. Ther Clin Risk Manag. 2018;14:1417-21.
20. Venema S, Abbas F, van de Belt-Gritter B, van der Mei HC, Busscher HJ, van Hoogmoed CG. In vitro oral biofilm formation on triclosan-coated sutures in the absence and presence of additional antiplaque treatment. J Oral Maxillofac Surg. 2011 Apr;69(4):980-5.
21. Alfhili MA, Lee MH. Triclosan: An update on biochemical and molecular mechanisms. Oxid Med Cell Longev. 2019 May;2019:1607304.
22. Wade WG, Addy M. Antibacterial activity of some triclosan-containing toothpastes and their ingredients. J Periodontol. 1992 Apr;63(4):280-2.
23. Heaven CJ, Davison CR, Cockcroft PM. Bacterial contamination of nylon corneal sutures. Eye. 1995 Jan;9(1):116-8.
24. Asher R, Chacartchi T, Tandlich M, Shapira L, Polak D. Microbial accumulation on different suture materials following oral surgery: a randomized controlled study. Clin Oral Investig. 2019 Feb;23(2):559-65.
25. Sala-Perez S, Lopez-Ramirez M, Quinteros-Borgarello M, Valmaseda-Castellon E, Gay-Escoda C. Antibacterial suture vs silk for the surgical removal of impacted lower third molars. A randomized clinical study. Med Oral Patol Oral Cir Bucal. 2016 Jan;21(1):e95-102.
26. Pelz K, Todtmann N, Otten JE. Comparison of antibacterial-coated and non-coated suture material in intraoral surgery by isolation of adherent bacteria. Ann Agric Environ Med. 2015;22(3):551-5.
27. Masini BD, Stinner DJ, Waterman SM, Wenke JC. Bacterial adherence to suture materials. J Surg Educ. 2011 Mar;68(2):101-4.
28. Edmiston CE, Seabrook GR, Goheen MP, Krepel CJ, Johnson CP, Lewis BD, et al. Bacterial adherence to surgical sutures: can antibacterial-coated sutures reduce the risk of microbial contamination? J Am Coll Surg. 2006 Oct;203(4):481-9.
29. Ferguson RE, Jr., Schuler K, Thornton BP, Vasconez HC, Rinker B. The effect of saliva and oral intake on the tensile properties of sutures: an experimental study. Ann Plast Surg. 2007 Mar;58(3):268-72.
2. Jager DHJ, Maarse F, Klausch T, Karagozoglu KH, Ten Bruggenkate CM, Sandor GK, et al. Wound dehiscences following pre-implant bone augmentation with autogenous iliac crest bone grafts: A retrospective cohort study. Int J Oral Implantol (New Malden). 2019 Jan;12(2):227-36.
3. Otten JE, Wiedmann-Al-Ahmad M, Jahnke H, Pelz K. Bacterial colonization on different suture materials--a potential risk for intraoral dentoalveolar surgery. J Biomed Mater Res B Appl Biomater. 2005 Jul;74(1):627-35.
4. Koyuncuoglu CZ, Yaman D, Kasnak G, Demirel K. Preference of suture specifications in a selected periodontal and implant surgeries in Turkey. Eur J Dent. 2019 Feb; 13(1):108.
5. Tabrizi R, Mohajerani H, Bozorgmehr F. Polyglactin 910 suture compared with polyglactin 910 coated with triclosan in dental implant surgery: randomized clinical trial. Int J Oral Maxillofac Surg. 2019 Oct;48(10):1367-71.
6. Dhom J, Bloes DA, Peschel A, Hofmann UK. Bacterial adhesion to suture material in a contaminated wound model: Comparison of monofilament, braided, and barbed sutures. J Orthop Res. 2017 Apr;35(4):925-33.
7. Lafaurie GI, Sabogal MA, Castillo DM, Rincon MV, Gomez LA, Lesmes YA, et al. Microbiome and Microbial Biofilm Profiles of Peri-Implantitis: A Systematic Review. J Periodontol. 2017 Oct;88(10):1066-89.
8. Rakic M, Grusovin MG, Canullo L. The microbiologic profile associated with peri-implantitis in humans: A systematic review. Int J Oral Maxillofac Implants. 2016 Mar;31(2):359-68.
9. Albertini M, Lopez-Cerero L, O'Sullivan MG, Chereguini CF, Ballesta S, Rios V, et al. Assessment of periodontal and opportunistic flora in patients with peri-implantitis. Clin Oral Implants Res. 2015 Aug;26(8):937-41.
10. Zhuang LF, Watt RM, Mattheos N, Si MS, Lai HC, Lang NP. Periodontal and peri-implant microbiota in patients with healthy and inflamed periodontal and peri-implant tissues. Clin Oral Implants Res. 2016 Jan;27(1):13-21.
11. Canullo L, Rossetti PH, Penarrocha D. Identification of Enterococcus faecalis and Pseudomonas aeruginosa on and in implants in individuals with peri-implant disease: A cross-sectional study. Int J Oral Maxillofac Implants. 2015 May;30(3):583-7.
12. Narendrakumar K, Kulkarni M, Addison O, Mazare A, Junkar I, Schmuki P, et al. Adherence of oral streptococci to nanostructured titanium surfaces. Dent Mater. 2015 Dec;31(12):1460-8.
13. Meza-Siccha AS, Aguilar-Luis MA, Silva-Caso W, Mazulis F, Barragan-Salazar C, Del Valle-Mendoza J. In Vitro evaluation of bacterial adhesion and bacterial viability of Streptococcus mutans, Streptococcus sanguinis, and Porphyromonas gingivalis on the abutment surface of titanium and zirconium dental implants. Int J Dent. 2019 Jun;2019:4292976.
14. Obermeier A, Schneider J, Harrasser N, Tubel J, Muhlhofer H, Pforringer D, et al. Viable adhered Staphylococcus aureus highly reduced on novel antimicrobial sutures using chlorhexidine and octenidine to avoid surgical site infection (SSI). PLoS One. 2018 Jan;13(1):e0190912.
15. Yang Y, Yang SB, Wang YG, Zhang SH, Yu ZF, Tang TT. Bacterial inhibition potential of quaternised chitosan-coated VICRYL absorbable suture: An in vitro and in vivo study. J Orthop Translat. 2017 Jan;8:49-61.
16. Fowler JR, Perkins TA, Buttaro BA, Truant AL. Bacteria adhere less to barbed monofilament than braided sutures in a contaminated wound model. Clin Orthop Relat Res. 2013 Feb;471(2):665-71.
17. Brandt MT, Jenkins WS. Suturing principles for the dentoalveolar surgeon. Dent Clin North Am. 2012 Jan;56(1):281-303.
18. Balamurugan R, Mohamed M, Pandey V, Katikaneni HK, Kumar KR. Clinical and histological comparison of polyglycolic acid suture with black silk suture after minor oral surgical procedure. J Contemp Dent Pract. 2012 Jul;13(4):521-7.
19. Zhang Q, Zhang C, Fang X, Luo X, Guo J. Biomaterial suture Vicryl Plus reduces wound-related complications. Ther Clin Risk Manag. 2018;14:1417-21.
20. Venema S, Abbas F, van de Belt-Gritter B, van der Mei HC, Busscher HJ, van Hoogmoed CG. In vitro oral biofilm formation on triclosan-coated sutures in the absence and presence of additional antiplaque treatment. J Oral Maxillofac Surg. 2011 Apr;69(4):980-5.
21. Alfhili MA, Lee MH. Triclosan: An update on biochemical and molecular mechanisms. Oxid Med Cell Longev. 2019 May;2019:1607304.
22. Wade WG, Addy M. Antibacterial activity of some triclosan-containing toothpastes and their ingredients. J Periodontol. 1992 Apr;63(4):280-2.
23. Heaven CJ, Davison CR, Cockcroft PM. Bacterial contamination of nylon corneal sutures. Eye. 1995 Jan;9(1):116-8.
24. Asher R, Chacartchi T, Tandlich M, Shapira L, Polak D. Microbial accumulation on different suture materials following oral surgery: a randomized controlled study. Clin Oral Investig. 2019 Feb;23(2):559-65.
25. Sala-Perez S, Lopez-Ramirez M, Quinteros-Borgarello M, Valmaseda-Castellon E, Gay-Escoda C. Antibacterial suture vs silk for the surgical removal of impacted lower third molars. A randomized clinical study. Med Oral Patol Oral Cir Bucal. 2016 Jan;21(1):e95-102.
26. Pelz K, Todtmann N, Otten JE. Comparison of antibacterial-coated and non-coated suture material in intraoral surgery by isolation of adherent bacteria. Ann Agric Environ Med. 2015;22(3):551-5.
27. Masini BD, Stinner DJ, Waterman SM, Wenke JC. Bacterial adherence to suture materials. J Surg Educ. 2011 Mar;68(2):101-4.
28. Edmiston CE, Seabrook GR, Goheen MP, Krepel CJ, Johnson CP, Lewis BD, et al. Bacterial adherence to surgical sutures: can antibacterial-coated sutures reduce the risk of microbial contamination? J Am Coll Surg. 2006 Oct;203(4):481-9.
29. Ferguson RE, Jr., Schuler K, Thornton BP, Vasconez HC, Rinker B. The effect of saliva and oral intake on the tensile properties of sutures: an experimental study. Ann Plast Surg. 2007 Mar;58(3):268-72.
| Issue | Vol 18 (Continuously Published Article-Based) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v18i25.6935 | |
| Keywords | ||
| Sutures Silk Nylon Polyglactin 910 Bacteria Escherichia coli Streptococcus Dental implants Enterococcus faecalis; Staphylococcus; | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Nadafpour N, Montazeri M, Moradi M, Ahmadzadeh S, Etemadi A. Bacterial Colonization on Different Suture Materials Used in Oral Implantology: A Randomized Clinical Trial. Front Dent. 2021;18.
