Bacterial Colonization on Different Suture Materials Used in Oral Implantology: A Randomized Clinical Trial

Objectives: This study aimed to compare the colonization of Enterococcus faecalis (E. faecalis), Escherichia coli (E. coli), Streptococcus mutans (S. mutans) and Staphylococcus aureus (S. aureus) isolated from the oral cavity on different suture materials used in oral implantology. Materials and Methods: Patients scheduled for implant surgery were included in this study. After flap approximation, the surgical site was sutured using silk, nylon, polyglactin 910 (Vicryl(®)) and triclosan-coated polyglactin 910 (Vicryl(®) Plus) sutures in a randomized order. Seven days after surgery, the sutures were removed and incubated in bile esculin agar (for E. faecalis), MacConkey agar (for E. coli), mitis salivarius agar (for S. mutans), and mannitol salt agar (for S. aureus) at 37°C for 24 h. The colonies were then counted. Data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests. Results: Vicryl(®) sutures showed the highest accumulation of E. faecalis, followed by Vicryl(®) Plus, nylon, and silk. There was no significant difference between nylon and silk (P=0.5) or between Vicryl(®) and Vicryl(®) Plus (P=0.4). Vicryl(®) Plus sutures showed the highest accumulation of E. coli followed by Vicryl(®), silk and nylon (P<0.01). Vicryl(®) sutures showed the highest accumulation of S. mutans, followed by Vicryl(®) Plus, silk, and nylon. Vicryl(®) Plus sutures showed the highest accumulation of S. aureus, followed by Vicryl(®), nylon, and silk. Conclusion: Nylon sutures showed the least microbial accumulation. Vicryl(®) and triclosan-coated Vicryl(®) Plus sutures had no advantage over the commonly used silk sutures in decreasing the number of bacteria.