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Department of oral /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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  • 1. DEPARTMENT OF ORAL &MAXILLOFACIAL SURGERY INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  • 2. CONTENTS   1.IDEAL REQUIREMENTS OF A SUTURE MATERIAL  2.SIGNIFICANCE OF SIZES  3.PRINCIPLES OF SUTURING 4.CLASSIFICATION OF SUTURE MATERIAL 5.KNOT TYING  6.SUTURING TECHNIQUES 7.SUTURE REMOVAL 8.DRAINS 9.ALTERNATIVES TO SUTURING MATERIALS www.indiandentalacademy.com
  • 3. DEFINITION  Ideal requirements for a suture material:    1.Adequate strength    2.low tissue reaction    3.low capillarity    4.good handling & knotting properties   5.sterlization without deterioration in properties   www.indiandentalacademy.com
  • 4. SIGNIFICANCE OF SIZES  Sutures are numbered from sizes 1-0 to 9-0  Greater the number of sizes,the thinner the material  Thick sutures are used for approximation of deeper layers, wounds in tension prone areas and for ligation of blood vessels.  Thin sutures are used for closing delicate tissues like conjunctiva& skin incisions of the face.  5-0&6-0 generally used for skin closure in head & neck.  3-0&4-0 are used intraorally www.indiandentalacademy.com
  • 5. PRINCIPLES OF SUTURING  The needle should be grasped at approximately 1/3rd the distance from the eye& 2/3rds from the point.  The needle should enter the tissues perpendicular to the tissue surface. The needle should be passed through the tissues along its curve.   The suture should be passed at an equal depth&distance from the incision on both sides.  The needle should always pass from the movable tissue to the fixed tissue.  The needle should always pass through the thin tissue to the thick tissue. www.indiandentalacademy.com
  • 6.  Tissues must never be closed under tension,undermining the tissues must be done prior to suturing in such cases.    The suture should be tied only to approximate the tissues,not to blanch.    The knot should never lie on the incision line.    Sutures should be placed at a greater depth than the distance from the incision so as to evert the wound margins.    Skin sutures are removed in 5 days& intraoral sutures in 7 days.   www.indiandentalacademy.com
  • 7. CLASSIFICATION OF SUTURE MATERIALS  SUTURES ABSORBABLE SYNTHETIC MONOF ILAMENT NON-ABSORBABLE SYNTHETIC NATURAL MULTI FILAMENT MONOFILAMENT MONOFI LAMENT NATURAL MULTI FILAMENT MONO FILAME NT MULTI FILAMENT www.indiandentalacademy.com MULTIF LAMEN
  • 8. Knot tying:  The surgeon may use either instrument tie/hand tie.instrument tie is more convenient in closed areas like mouth.  [1] square knot-formed by wrapping suture around needle holder once in opposite directions between the ties.atleast 3 ties are recommended.  www.indiandentalacademy.com
  • 9.  [2] surgeons knot-formed by 2 throws of the suture around the needle holder on the first tie& one throw in the opposite direction in the second tie.  www.indiandentalacademy.com
  • 10.  [3] grannys knot-this involves a tie in one direction followed by a single tie in the same direction as first& a 3rd tie in the opposite direction to square the knot& hold it permanently www.indiandentalacademy.com
  • 11. SUTURING TECHNIQUES  INTERUPPTED SUTURES  CONTINOUS SUTURES HORIZONTAL  MATTRESS SUTURES VERTICAL  FIGURE OF EIGHT  SUBCUTICULAR SUTURES www.indiandentalacademy.com
  • 12. INTERRUPTED SUTURES www.indiandentalacademy.com
  • 13. CONTINOUS SUTURURING www.indiandentalacademy.com
  • 14. VERTICAL MATTRESS SUTURES www.indiandentalacademy.com
  • 15. HORIZONTAL MATTRESS SUTURES www.indiandentalacademy.com
  • 16. FIGURE –OF-EIGHT-SUTURE www.indiandentalacademy.com
  • 17. SUB-CUTICULAR SUTURES www.indiandentalacademy.com
  • 18. SUTURE REMOVAL www.indiandentalacademy.com
  • 19. DRAINS  Definition Indications open  Types Closed  Management   active Removal www.indiandentalacademy.com passive
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  • 26. Complications of drains www.indiandentalacademy.com
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  • 33. ALTERNATIVES TO SUTURING MATERIALS  Surgical staples  Tissue adhesives  Adhesive tapes www.indiandentalacademy.com
  • 34. REFERENCES    1.ORAL AND MAXILLOFACIAL SURGERY-LASKIN-VOL(1)   2. Mechanical Properties of Polyglycolic Acid Sutures in Oral Surgery  J. B. MOSER, E. P. LAUTENSCHLAGER, and B. J. HORBAL- J DENT RES 1974 ,53: 804    3.GUIDE TO SUTURE MATERIALS,TECHNIQUES & KNOTS -Zum Kugelfang- 4TH EDITION,SEP-2006   4.SUTURING –THE BASICS-PRACTICAL PLASTIC SURGERY FOR NONSURGEONS-1990    5. Edgerton M: The Art of Surgical Technique. Baltimore, Williams & Wilkins,  1988. www.indiandentalacademy.com
  • 35. 6. McCarthy JG: Introduction to plastic surgery. In McCarthy JG (ed):  Plastic Surgery.      Philadelphia, W.B. Saunders, 1990, pp 48–54.    7.SURGICAL DRAINS ,CATHS,TUBES&CENTRAL LINES- A  comprehensive Study      Al-Momtan, Ahmed T.-2010  www.indiandentalacademy.com
  • 36. www.indiandentalacademy.com

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