In-vitro evaluation of commonly used beverages on tensile strength of different suture materials used in dental surgeries

Immediate effect of different herbal solutions on tensile strength of suture materials in oral cavity

This pilot study evaluated the immediate effect of different herbal solutions in oral use on the tensile strength of the sutures used in oral surgical procedures. Three frequently used suture materials, polyglactin 910 (PGA), poliglecaprone (PGCL), and polypropylene (PP), were chosen in a 4-0-gauge size. The sutures' tensile stress was evaluated before being immersed (baseline) and after immersion at 24 h, 1 week, and 2 weeks in four different media: artificial saliva, chlorhexidine, Commiphora myrrh, and frankincense. The tensile strength was assessed by applying a 50 N load at a standardized speed of 2 mm/min. The data were analyzed using one-way and three-way analysis of variance (ANOVA) and the Tukey post hoc test with a significance level of p ≤ 0.05 significance level. The mean values of the maximum load showed a significant statistical difference across the three types of sutures (PGA, PGCL, and PP). The mean tensile strength of the PP suture was statistically lower than that of the other sutures. There was a statistically significant difference in the mean tensile strength of the PGA suture when stored in chlorohexidine media and the PGCL suture for frankincense media. The tensile strength for all sutures was the lowest value when immersed in Commiphora myrrh media. Home-prepared herbal solutions can affect the tensile strength and maximum load of suture materials. Careful and controlled use of herbal solutions after any dental surgical procedures is advisable.

Investigation of Absorbable and Non-Absorbable Multifilament Suture Materials in Terms of Strength Changes Using Chlorhexidine Mouthwash and Thermal Cycling: An In Vitro Study

Sutures are natural or synthetic biomaterials utilized to hold tissues together. Following oral surgery, the surgical site and sutures are physically affected by many different factors. This study was conducted to evaluate the effect of artificial saliva (AS) and chlorhexidine mouthwash on the tensile strength of absorbable multifilament PGLA (polyglycolide-co-l-lactide) and non-absorbable multifilament silk sutures. PGLA and silk sutures, which are commonly used in oral surgery, were used to evaluate the change in strength of the sutures. A total of 352 suture samples were divided into eight equal groups (n = 44) and used for the experiments. Tensile strength was tested on days 0, 3, 7, and 14. For the silk sutures, there was a significant decrease in tensile strength in all groups at time T3 compared to T0, T1, and T2, and at times T1 and T2 compared to T0. For PGLA sutures, there was a significant decrease in all groups at time T3 compared to T0, T1, and T2. This study shows that chlorhexidine mouthwash significantly reduces suture resistance for 14 days after surgery.

Evaluation of Tensile Strength of Surgically Absorbable Suture Materials Used in Oral Surgery after Immersion in Different Beverages: An In Vitro Study

Suture materials are natural or synthetic biomaterials used to close tissues together. After surgical procedures in the mouth, the surgical site and the sutures are physically affected by many different factors. This study was conducted to evaluate the effects of frequently consumed beverages on the tensile strength of monofilament PGLA (polyglycolide-co-l-lactide) and multi-filament PGCL (polyglycolide-co-caprolactone) absorbable sutures. In particular, PGLA and PGCL absorbable sutures, which are frequently used in oral surgery, were used to evaluate the change in the strength of suture materials. The suture materials were soaked in tea, coffee, and cola drinks five times a day for 5 min each and the rest of the time in artificial saliva. All suture materials were aged via thermal cycling. Tensile strengths were tested at 0, 3, 7, and 14 days. Mixed ANOVA (four replicates: within-group comparison and two factors: between-group comparison) was performed to evaluate the effects of groups and time on the tension levels of the Tekmon and Vicryl suture materials. Analysis of Variance was used for the within- and between-group comparisons, with the Bonferroni corrected t-test for multiple comparisons. For the PGCL suture material, there were significant decreases in tension levels in artificial saliva, tea, coffee, and cola at time T3 compared to T0, T1, and T2, and at T1 and T2 compared to T0. For the PGLA suture material, there were significant decreases in tension levels in artificial saliva, tea, coffee, and cola at time T3 compared to T0, T1, and T2. There was also a significant decrease in tension level at time T2 in cola compared to T0. The present study demonstrates that beverages significantly decrease the strength of suture materials for 14 days after surgery. In particular, cola decreased the resistance of the PGCL suture material more significantly in the first week when compared to other beverages.

In Vitro Study of Tensile Strength Comparison of Selected Nonabsorbable and Absorbable Suture Materials after Immersion in 0.12% Chlorhexidine Gluconate

Aim

To compare the tensile strength (TS) of absorbable and nonabsorbable suture materials after immersion in 0.12% chlorhexidine gluconate.

Materials and Methods

Six 4-0-gauge suture materials were used, namely silk (S), polypropylene (PP), polyamide 6 (PA6), polyglactin 910 (PG910), poliglecaprone 25 (PL25), and polydioxanone (PDX). A total of 540 suture materials were divided equally (90) into six groups and tested. These materials were divided into a nonimmersed condition (10) and two thermostatically controlled immersion media (40 each), using artificial saliva for the control group (CG) and 0.12% chlorhexidine gluconate for the test group (TG). The specimens were tied to prefabricated rubber rods before immersion and removed at the testing timepoint. By using a universal testing machine (Instron 5566) with hooks attached, a hook-mounted specimen TS testing was performed on days 0, 1, 3, 7, and 14 at a 10 mm/min crosshead speed until the material was stretched to failure, and the maximum TS was recorded in Newtons (N). The continuous variables were taken as the mean and standard deviation across the six study groups to assess the significance at α = 0.05. A two-factor analysis of variance (ANOVA) was performed to assess the TSs over time in different media. A Bonferroni correction was performed when the data were statistically significant according to a two-factor ANOVA. Intragroup statistical comparisons were performed by repeated ANOVA for each study group. All data were analyzed using SPSS 26.

Results

The suture material TS analysis showed that nonabsorbable suture materials maintained their TS throughout the study; silk exhibited different behaviors, decreasing in TS from baseline to day 1 and maintaining its TS until day 14. All absorbable suture materials decreased in TSs by day 14. The silk and PG910 samples in the TG performed significantly better than those in the CG.

Conclusions

Prescribing 0.12% chlorhexidine gluconate as a postsurgical mouth rinse is safest when silk and PG910 are the optimal suture materials.

Development of Biocompatible Ciprofloxacin-Gold Nanoparticle Coated Sutures for Surgical Site Infections

Surgical site infections (SSIs) are mainly observed after surgeries that use biomaterials. The aim of this present work was to develop ciprofloxacin hydrochloride (CPH)-loaded gold nanoparticles. These ciprofloxacin-gold nanoparticles were coated onto a sterile surgical suture using an adsorption technique, followed by rigidization via ionotropic crosslinking using sodium alginate. Furthermore, UV-visible spectroscopy, infrared spectroscopy, and scanning electron microscopy were used to characterize the samples. The particle size of the nanoparticles was 126.2 ± 13.35 nm with a polydispersity index of 0.134 ± 0.03, indicating nanosize formation with a monodispersed system. As per the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines, stability studies were performed for 30 days under the following conditions: 2-8 °C, 25 ± 2 °C/60 ± 5% RH, and 40 ± 2 °C/75 ± 5% RH. For both Gram-negative and Gram-positive bacteria, the drug-coupled nanoparticle-laden sutures showed a twofold higher zone of inhibition compared with plain drug-coated sutures. In vitro drug release studies showed a prolonged release of up to 180 h. Hemolysis and histopathology studies displayed these sutures' acceptable biocompatibility with the healing of tissue in Albino Swiss mice. The results depict that the use of antibiotic-coated sutures for preventing surgical site infection for a long duration could be a viable clinical option.