Clinicians perform bone grafts after tooth extractions to preserve the integrity of the jawbone. Often, the graft material will lose its shape as the soft tissue is sutured. This complication can be prevented with the use of “tenting” screws or tacks to help keep the graft in place, though removing the screws or tacks requires a second retrievable surgery and additional treatment costs.
To avoid these issues, the Continuous Periosteal Strapping Suture (CPSS) technique uses resorbable sutures and membrane that can be assimilated into the body. Developed by researchers at the University of Minnesota, Minn, and the Implant Cosmetic Dental Center in Silver Spring, Md, CPSS requires a less complex surgical procedure than currently available techniques and leads to lower overall treatment costs.
Instead of surgical screws or tacks, a series of intricate knots made with resorbable sutures surrounding the membrane are used to keep the graft in place. The knots help to maintain the strength of the sutures, creating a firmer hold on the wound closure area. With the use of resorbable materials, there is no need for a separate surgery to remove screws or tacks.
Also, by using sutures with a higher tension rate or tensile strength, the technique increases the duration of the suture time from 56 to 70 days to 91 to 119 days. This increased tensile strength for a longer period will be a critical part of membrane and graft stabilization, the researchers say, because the longer-lasting sutures will help ensure the sustainability of the procedure.
“One of the biggest challenges when osseous grafting to the ridge to widen the site with particulate material is containing the graft and avoiding lateral displacement during healing,” said researcher Gregori M. Kurtzman, DDS, of the Implant Cosmetic Dental Center. “The CPSS technique predictably helps contain the graft without the need for an increase in material costs or complicated techniques.”
The researchers conclude that although their technique is limited by the tensile strength and resorption rate of the specific suture used, they still found it to have fewer complications and predictable outcomes. They also suggest that future studies should be conducted comparing the CPSS technique with other membrane fixation techniques such as “tenting” screw or tack techniques.
The study, “Continuous Periosteal Strapping Sutures for Stabilization of Osseous Grafts with Resorbable Membranes for Buccal Ridge Augmentation: A Technique Report,” was published by the Journal of Oral Implantology.