How to do Tension-free Sutures for Dental Implant or Bone Augmentation?
To obtain tension free primary closure, the buccal full thickness flap periosteum was scored using horizontal releasing incisions (Periosteum releasing) and spreading by Metzenbaum scissors or Scaple after insertion into the tissue. The flap was approximated using Gortex® (Gore, Flagstaff, AZ) sutures or monofilament sutures. These sutures prevent wicking of bacteria into the graft as well as maintain tensile strength. One cannot overly emphasize the importance of establishing and maintaining primary closure following bone-grafting procedures. The sutures were removed two weeks postoperative. The patient agreed to refrain from wearing a prosthesis over this area thus facilitating undisturbed healing. 
Tension-free primary sutures technique
(Edentulous Ridge Expansion + Bone Augmentation): Surgery by Perio
posted by Ajou Huang @ 9:24 AM
2 comments
2 Comments:
Tension-free suture(TFS) technique is a skill should be learned for dental implantation or/and bone augmentation.
Some points for TFS:
1.Flap released as far as possible
2.Antiswelling (steroid & NSAIDs)drugs may be prescribed
3.Post Sx ecchymosis will be occurred;3 days for cold packing,hot packing later for 1~2 wks
4.Mattress suture combined with continous suture are suggested
5.Overlaying denture should be avoid after surgery
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Ice packing after GBR / Bone augmentation with tension free sutures will help OP site to stop bleeding, decrease swelling and pain. It shall be continous for 3~4 days. The less swollen, the better for result. After that, it will change to hot moist packing for decreaseing swelling and dissolving the blood clot or ecchymosis in the shortest time! Heat will stimulate the w'd start to early healing.
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