Human Fibrin Glue Versus Sutures in Periodontal Surgery

Abstract

A fibrin-sealing system consisting of symmetrical flap and graft procedures versus silk sutures in a split-mouth clinical trial was tested in 51 patients. Clinical parameters and operative times were recorded and compared. In clinical use, the fibrin glue provided quick hemostasis and adequate tissue adhesion on the whole inner surface of grafts or flaps. Its use saved remarkable amounts of time and made it easier to fix tissues in difficult areas. The time saved ranged from 3 to 19.5 minutes per procedure, and 1 to 8.5 minutes per tooth. The convenience of the fibrin glue was especially appreciated in pedicle flap procedures.

Fibrin Adhesive Derived From Snake Venom in Periodontal Surgery

“…Among the tissular adhesives used as adjuvants to or substitutes for sutures, fibrin adhesives aim to mimic and expand the final phase of blood coagulation, that is, the conversion of fibrinogen into fibrin. In periodontal surgery, the fibrin adhesive used as a substitute for suture has been shown to increase the number of fibroblasts during tissue repair, has excellent adhesive properties, and promotes less inflammation than silk sutures during the first 2 weeks after periodontal surgery 1‐3 . In clinical use, fibrin glue provides quick hemostasis and adequate tissue adhesion on the whole inner surface of grafts or flaps, as well as saving remarkable amounts of time and making it easier to fix tissues in difficult areas 3 .…”

“…In periodontal surgery, the fibrin adhesive used as a substitute for suture has been shown to increase the number of fibroblasts during tissue repair, has excellent adhesive properties, and promotes less inflammation than silk sutures during the first 2 weeks after periodontal surgery 1‐3 . In clinical use, fibrin glue provides quick hemostasis and adequate tissue adhesion on the whole inner surface of grafts or flaps, as well as saving remarkable amounts of time and making it easier to fix tissues in difficult areas 3 . Because the adhesive is slowly resorbed throughout the tissue repair, some authors 4,5 have evaluated the use of this material for favoring recolonization of the root surface by cells from the periodontal ligament.…”

A comparative evaluation of bovine-derived xenograft (Bio-Oss Collagen) and type I collagen membrane (Bio-Gide) with bovine-derived xenograft (Bio-Oss Collagen) and fibrin fibronectin sealing system (TISSEEL) in the treatment of intrabony defects: A clinico-radiographic study

“…[24] The prolonged fixation of the fibrin glue into the surgical wound is the property that allows its use as a sustained local delivery carrier. In addition, human fibrin glue is rich in fibronectin, which has been reported to favor new attachment formation by adhering to root surfaces and promoting fibroblasts and periodontal ligament cells migration.…”

A comparative study on the efficacy of a commercial fibrin adhesive (Tisseel®) vis-à-vis silk suture on wound closure following periodontal surgical procedures

“…[12] The mobility of the flap/graft was tested with a blunt instrument after a period of 5 minutes. In fibrin adhesive material (FAM) cases, there was firm adhesion and no mobility of flaps could be elicited.…”