Healing and Flap Closure Time with N-butyl Cyanoacrylate and Silk Suture
, Research Article

Healing and Flap Closure Time with N-butyl Cyanoacrylate and Silk Suture: A Split-mouth Study

Research Article
Published October 15, 2025
Dr. Asmita Koju
Dr. Shaili Pradhan
Dr. Ranjita Shrestha Gorkhali
Dr. Pramod Kumar Koirala
Dr. Gaurav Karna
Dr. Garima Khadka
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Keywords

Flap closure time; healing; n-butyl cyanoacrylate; periodontal flap surgery; silk suture.

Abstract

Introduction: Silk suture is the most commonly used material in periodontal flap surgery. However, healing thereafter may be compromised due to accumulation of food particles into the suture knots and bacterial ingress into the site. Recently, n-butyl cyanoacrylates have emerged in periodontics that may overcome the limitations of intraoral usage of silk suture. 


Objective: To compare effectiveness of n-butyl cyanoacrylate with silk suture in the closure of periodontal flaps by assessing healing and flap closure time.


Methods: A split-mouth study was carried out amongst 16 patients indicated for bilateral periodontal flap surgeries in Periodontology and Oral Implantology Unit, National Academy of Medical Sciences (NAMS), Bir Hospital from 2022 September to 2023 August. Each patient served as his own control creating two sites: control site (4-0 silk suture) and test site (n-butyl cyanoacrylate); and flap closure time (FCT) for both sites was recorded. Inter-site comparison with Plaque index (PI), Papillary marginal attachment index (PMAI), and wound healing index (WHI) was performed for 3rd, 7th, and 30th post-operative days.


Results: The FCT was statistically higher for control site than test site. Similarly, PI and PMAI were statistically increased in the control site on 3rd and 7th post-operative days (p <0.005). There was no change in WHI between the sites.


Conclusion: This study suggests that n-butyl cyanoacrylate is as effective as silk suture for the closure of periodontal flaps. The easier application, less flap closure time and requirement of little armamentarium make n-butyl cyanoacrylate a promising alternative.

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