Comparative evaluation of wound closure and healing following periodontal flap surgery using silk sutures and N-Butyl cyanoacrylate tissue adhesive in stage II/III periodontitis: A short-term clinical study

• Author Details:   
• Natasha Handoo ^*
• Gurpreet Kaur
• Navneet Kaur
• Tania Goutam
• Lolakshi Kachroo

---

View PDF

Background: Primary closure after periodontal flap surgery is critical to ensure stable clot formation, minimize bacterial ingress, and promote uneventful healing. Conventional silk sutures are widely used but may act as plaque-retentive factors and exacerbate inflammation. N-butyl cyanoacrylate (NBC) adhesive polymerizes rapidly, providing immediate hemostasis, bacteriostatic action, and tissue sealing.

Materials and Methods: Twenty patients with Stage II/III periodontitis were randomly allocated into two groups: Group I (n=10) underwent flap closure with 3-0 braided silk sutures, and Group II (n=10) received closure with NBC tissue adhesive. Outcomes evaluated at day 7 and day 21 included tissue color, incision margin approximation, bleeding on palpation, suppuration, and pain using a 10-point visual analogue scale (VAS). Landry’s Healing Index was used for overall healing assessment. Statistical analysis was performed using SPSS v23; independent t-tests and Chi-square/Fisher’s exact tests were applied with significance at p≤0.05.

Results: At day 7, NBC showed significantly superior outcomes across all parameters: improved tissue color (p=0.041), incision margin adaptation (p=0.025), less bleeding (p=0.021), reduced suppuration (p=0.041), and lower VAS scores (1.3 vs 3.0; p=0.001). By day 21, no significant intergroup differences were observed (p>0.05 for all), although both groups exhibited excellent healing.

Conclusion: NBC tissue adhesive offers superior early healing and greater patient comfort compared with silk sutures, with comparable outcomes at three weeks. NBC represents a reliable alternative to conventional sutures in periodontal flap surgery.