Evaluation and comparison of the efficacy of autologous fibrin glue with 4-0 resorbable mono filament sutures following implant placement-a randomized clinical trial

Traditional sutures in dentistry, while commonly used for intraoral wound closure, have several drawbacks, including tissue trauma, food debris accumulation, and potential for stitch abscess due to improper removal. These issues, coupled with patient discomfort, have driven the need for alternative closure methods. Tissue adhesives, such as fibrin sealants, cyanoacrylates, and collagen-based compounds, have emerged as viable options. These adhesives create a strong bond between wound edges, preventing separation, and are easier to apply. However, some tissue adhesives, like cyanoacrylates, have toxic degradation products that pose risks, making them less favorable. Fibrin glue, introduced in the 1940s, is commonly used but has limitations, including the risk of allergic reactions and viral transmission from its bovine-derived components. Commercial fibrin glue is also expensive. Autologous fibrin glue (AFG), derived from the patient’s own blood, addresses these issues by reducing the risk of infection, promoting faster healing, and being cost-effective. AFG also supports cell growth, differentiation, and acts as a scaffold for bone regeneration, making it a promising alternative to sutures. The study aims to evaluate and compare the efficacy of autologous fibrin glue with 4-0 resorbable monofilament sutures after implant placement. The study, conducted at the Department of Periodontology and Oral Implantology, I.T.S. Centre for Dental Studies and Research, will be a randomized clinical trial comparing autologous fibrin glue (AFG) and 4-0 resorbable monofilament sutures for wound closure following implant placement. A total of 24 edentulous sites will be randomly assigned to either AFG (Group 1) or sutures (Group 2). Participants, aged 18-65, with adequate oral hygiene and sufficient bone volume, will be included, while those with systemic diseases, poor oral hygiene, or other contraindications will be excluded. Clinical parameters, such as flap stability, wound healing indices, and pain perception, will be assessed along with radiographic evaluations of crestal bone levels. Histological analysis of wound healing characteristics will also be performed. Before surgery, patients will undergo scaling, root planing, and CBCT scans, followed by implant placement with either AFG or sutures. AFG will be prepared from the patient’s own blood using a modified method involving centrifugation and mixing with calcium chloride. The study aims to assess the efficacy of AFG in improving wound healing and tissue adaptation around dental implants.