Tissue adhesives for closure of intraoral surgical incisions: A systematic review and meta-analysis

Surgical success includes a planned incision, achieving haemostasis, good mechanical closure and optimal maintenance of the surgical wound. New materials, as tissue adhesives, have been suggested as substitutes for sutures, to overcome their disadvantages. This study aimed at gathering the differences of using surgical adhesives in oral surgery compared with the conventional method of using sutures as a wound closure technique. PRISMA analyses, PICO criteria and PubMed/Medline database, EBSCO and Cochrane Library were used for research. Inclusion criteria included prospective, randomized controlled trials and case-control studies published in English with full access, where clinical advantages and demerits/limitations were reported in patients who underwent oral surgical incisions, without time restrictions. Exclusion criteria comprised literature with lower level of evidence. A total of 15 studies were assessed and analysed 15 parameters as alternatives to sutures (100%), cost-effectiveness (6,6%), postoperative pain (53,3%), time consumption (73,3%), haemostasis (46,6%), homeostasis (13,3%), aids healing (26,6%), tissue inflammation (26,6%), safety (6,6%), graft dimension (3,13), biocompatibility (13,3%), adhesion to tissue (6,6%), bacteriostatic effect (20%), oedema (13,3%) and ease of application (26,6). Selected articles' results indicate that surgical glues can be a suitable alternative and/or adjuvant to oral sutures, presenting numerous advantages.