Influence of Suture Type on Implant Wound Healing and Bacterial Adherence

Abstract

Suture selection influences wound healing, patient comfort, and infection risk in implant surgery. Although monofilament sutures are commonly recommended for implant surgery, the comparative clinical performance of different types of monofilament sutures remains underexplored. This study compared the clinical and microbiological performance of polyamide and polytetrafluoroethylene (PTFE) sutures. A split-mouth design was used in 19 patients (38 implant sites) to compare wound healing, patient comfort, and bacterial adherence associated with polyamide and PTFE sutures. Wound healing was assessed using the early wound healing score (EHS, 0–10 scale), patient comfort via a visual analog scale (VAS, 1–10), and bacterial colonization using real-time quantitative PCR (qPCR) analysis of seven oral pathogens. Knot retention was recorded on days 0 and 7. Mean early wound healing scores were similar between PTFE (6.47 ± 0.52) and polyamide (6.63 ± 0.63) (p > 0.05). No significant differences were found between the two groups regarding surrounding tissue irritation (p > 0.05). However, knot stability decreased significantly for both materials, with polyamide showing higher knot loss (44.4% vs. 22.2%, p = 0.008). A significant number of Porphyromonas gingivalis were detected in PTFE compared to polyamide, which demonstrated enhanced reepithelialization and minimal tissue reaction. Both suture types achieved satisfactory healing and patient comfort, but their distinct microbial adhesion patterns may influence long-term peri-implant outcomes. Polyamide demonstrated lower P. gingivalis colonization and better re-epithelialization, suggesting potential clinical advantages.