A. Burak Çankaya - The Art of Dental Suturing

THE ART OF DENTAL SUTURING

A CLINICAL GUIDE

THE ART OF DENTAL SUTURING

A CLINICAL GUIDE

A. Burak Çankaya, DDS

Professor

Istanbul University

Faculty of Dentistry

Department of Oral and Maxillofacial Surgery

Korkud Demirel, DDS

Professor

Istanbul University

Faculty of Dentistry

Department of Periodontology

First published in Turkish

"DİŞ HEKİMLERİ İÇİN CERRAHİ DİKİŞ SANATI KLİNİK REHBERİ – III"

© 2019 Quintessence Yayıncılık Tanıtım Paz. ve Dış. Tic. Ltd. Şti.,

Büyükdere Cad. Sakarya Aprt. 6/7 Şişli-İstanbul

A CIP record for this book is available from the British Library.

ISBN: 978-3-86867-558-0

Copyright © 2021

Quintessenz Verlags-GmbH

All rights reserved. This book or any part thereof may not be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, or otherwise, without prior written permission of the publisher.

Editing: Avril du Plessis, Quintessence Publishing Co Ltd, London, UK

Layout and Production: Quintessenz Verlags-GmbH, Berlin, Germany

On the path that Atatürk has paved, toward the aims that he has set...

ACKNOWLEDGMENT

The start of this project dates back to October 2017. Although we started with much enthusiasm and energy, it did not take us long to understand that putting what we know on paper does not easily translate to performing the procedures in the clinic. Looking for new ways of telling the story took us to Ferhat Çevik, a self-improving, open-minded digital illustrator. We had never met him in person as he lives in another city, but our e-mail correspondence worked out perfectly, resulting in the magnificent illustrations in this book.

Undoubtedly, the illustrations alone were not sufficient; we also had to include the hand instruments for suturing. In this regard, Giana Spasic from Hu-Friedy provided generous support, as she always has, supplying us with all the necessary instruments in the shortest possible time.

So here we were, two authors from two different surgical disciplines, attempting to tackle instrument photography, again believing that whatever we know and do is right. We procured a photo light box, on top of all the photography materials we already had, and started to take photographs of our hand instruments. However, we realized soon enough that taking product photographs was nothing like taking family photos. It took us eight Saturdays and a pile of less-than-ideal-quality photographs to realize that this was not our forte either and that we needed help from professionals. Ahmet Koçak from Kandemir Photography came to the rescue and provided full support.

We would like to express our gratitude to Dr Ertuğrul Çetinkaya, the Managing Editor of Quintessence Türkiye, who mentored us through the process, and language editor, Avril du Plessis, for her exceptional cooperation.

We would therefore like to express our gratitude to all these esteemed and enlightened people whose support was essential in making this book a reality. We would also each like to express our special thanks to one another, as co-authors, not merely for completing the book, but also for having a pleasant time and becoming good friends during this process.

January 2021

ABOUT THE AUTHORS

Professor A. Burak Çankaya, DDS, graduated from Kadıköy Anatolian High School in 1995, and from Istanbul University, Faculty of Dentistry, in 2000. He worked as a visiting lecturer at Klinikum Osnabrück GmbH – Klinik für Mund-, Kiefer-, Gesichtschirurgie in 2006 and 2007. He acquired his PhD in 2007 and became Professor in 2021. His professional areas of interest include impacted tooth surgery, dental traumatology, dental implants, and bone regeneration. He is a member of the Turkish Association of Oral and Maxillofacial Surgery. Contact information: cankaya@istanbul.edu.tr

Professor Korkud Demirel, DDS, graduated from Tarsus American School in 1980, and from Istanbul University, Faculty of Dentistry, in 1985. He worked as a visiting lecturer at New York University, Stony Brook School of Dentistry, Department of Periodontology in 1989 and 1990. He attained his PhD in 1992 and became Professor in 2002. He was awarded the title of Honorary Professor by the Ukrainian Academy of Postgraduate Education in 2018. His professional areas of interest include esthetic periodontal treatment, dental implants, bone regeneration, and smoking and gingival diseases. He was Past President of the Turkish Society of Periodontology, and was Past President of the European Federation of Periodontology. Contact information: demirel@istanbul.edu.tr; www.periokursu.com

CONTENTS

Acknowledgment

About the authors

Types of wound healing

Chapter 1: Wound healing

Introduction

Phases of wound healing

Hemostasis and inflammation

Proliferation

Remodeling and maturation

Typical characteristics of oral mucosal wound healing

Wound healing and systemic factors

Age

Nutrition

Dehydration

Diabetes

Nicotine intake

Diseases and/or therapies affecting the host defense mechanism

Drugs and wound healing

Antithrombotic therapy

Antiangiogenic agents

Antiresorptive agents

Corticosteroids

Local factors affecting wound healing

Direction and length of incision

Surface angle of incision

Hemostasis

Tissue moisture control

Removal of necrotic tissue and foreign bodies

Prevention of dead space in wounds

Tissue tension

Infection

Wound and clot stabilization

Blood supply to the wound site

Enhanced visualization

Recommended reading

Chapter 2: Suture materials and suturing instruments

Suture threads and needles

Physical properties of suture threads

Gauge

Physical structure

Capillarity

Tensile strength

Tissue passage

Knot-holding security

Elasticity

Shape memory

Absorption characteristics of suture threads

Absorbable suture threads

Absorbable natural suture threads

Absorbable synthetic suture threads

Non-absorbable suture threads

Non-absorbable natural suture threads

Non-absorbable synthetic suture threads

Suture needles

Needle anatomy

Hand instruments

Needle holders

Scissors

Tissue forceps

Tissue adhesives

Fibrin adhesives

Collagen and protein-based adhesives

Cyanoacrylates

Polyurethane adhesives

Recommended reading

Chapter 3: Suturing techniques