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.