Effect of crown-attached sutures on healing of experimental furcation defects in dogs

This study evaluates whether suturing of replaced flaps with crown-attached sutures, following reconstructive surgery, counteracts postoperative recession of the gingival margins and facilitates new attachment. Through-and-through furcation defects were created in the mandibular premolars of 5 beagle dogs. Bone was surgically removed from the furcation and around each root to a level 3 to 4 mm below the cemento-enamel junction. Steel wires were placed in the furcations for 6 weeks to enhance plaque formation. After 12 weeks, reconstructive surgery that included acid conditioning of root surfaces was performed. On 1 side of the mandible, the flaps were replaced and secured by bonding the sutures to the teeth with composite resin. On the other side, the replaced flaps were sutured interdentally with single sutures. The results demonstrated that the margins of flaps secured with interdental sutures shifted apically to the fornix of the furcations after 1 week, and histologically all 10 furcations were found to be lined with epithelium. Margins of flaps secured with crown-attached sutures remained an average of 0.5 mm coronally to the fornix, and 13 of the 14 teeth showed new attachment. The results indicate that a suturing technique which counteracts gingival recession, favours the formation of new attachment in this beagle dog model.