Academy for Learning by Sharing - ALS

Implant Surgery Suturing Guide

🔹 1. Simple Interrupted Suture

👉 সবচেয়ে common & versatile

✔️ Use:
• Routine implant placement
• ছোট flap closure
• Good primary closure থাকলে

👍 Advantage:
• Easy, quick
• যদি একটা knot খুলেও যায় → পুরো closure নষ্ট হয় না

⚠️ Tip:
• Tension-free closure নিশ্চিত করুন (flap stretch করবেন না)

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🔹 2. Horizontal Mattress Suture

👉 Flap stabilization & tension distribution

✔️ Use:
• যখন flap-এ tension বেশি
• GBR (bone graft) cases
• Membrane cover করার সময়

👍 Advantage:
• Wound edge evert করে → better healing
• Tension evenly distribute করে

⚠️ Tip:
• খুব tight দিলে tissue necrosis হতে পারে

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🔹 3. Vertical Mattress Suture

👉 Precise edge adaptation + eversion

✔️ Use:
• Esthetic zone (anterior maxilla)
• Papilla preservation cases

👍 Advantage:
• Excellent marginal adaptation
• Dead space কমায়

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🔹 4. Sling Suture

👉 Around healing abutment / দাঁত ঘিরে stabilization

✔️ Use:
• Healing abutment already placed
• Papilla shape maintain করতে

👍 Advantage:
• Tissue position control করা যায়
• Esthetic contour maintain

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🔹 5. Figure-of-8 Suture

👉 Socket বা implant cover protection

✔️ Use:
• Immediate implant after extraction
• Socket seal

👍 Advantage:
• Clot stabilize করে
• Easy & fast

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🔢 Suture Material + Size (Implant ক্ষেত্রে)

👉 Best combo (most cases):
• Material: Nylon / Prolene (monofilament)
• Size: 4-0 / 5-0

👉 Esthetic zone:
• 5-0 / 6-0

👉 GBR / graft:
• Slightly thicker → 4-0

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⚡ Practical Clinical Strategy (Very Important)

👉 শুধু technique না—biologic principle বেশি গুরুত্বপূর্ণ

🔥 Golden rules:
• ✅ Primary closure (tension-free)
• ✅ Minimal trauma
• ✅ Proper flap design
• ✅ Adequate blood supply maintain

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🎯 বাস্তব লাইফে কী করবেন?

👉 Most implant cases:
• Simple interrupted + occasional mattress (if tension)

👉 GBR case:
• Horizontal mattress + interrupted (combination)

👉 Esthetic anterior:
• Vertical mattress / sling

©Dr. Salsabil Aurnob