Periodontal flap closure using a simplified autologous fibrin glue preparation: A report of two successful cases

Abstract

Although suturing is an integral part of periodontal flap surgery, it has disadvantages such as difficulty in plaque control, increased postoperative discomfort, and higher infection rate. To overcome these problems, a search for alternatives and possibly a sutureless technique has continued. Fibrin glue is one such biological tissue adhesive, mimicking the final stages of coagulation with several advantages. This report shows the use of an autologous fibrin glue in two cases, prepared using a simplified method. At the end of periodontal flap surgery, the flaps were closed with sutures in two papillae and fibrin glue in other two papillae in both cases. The papillae closed with fibrin glue showed better healing and good stability after flap closure. This simplified preparation of autologous fibrin glue has not been reported till date as found from literature search.

Keywords: Autologous fibrin glue; fibrin adhesive; fibrin glue; fibrin glue tissue adhesive; fibrin sealing system.

Figure 1

Components for preparation of fibrin glue

Figure 2

Platelet-rich plasma + platelet-poor plasma separated in a test tube after the first centrifugation

Figure 3

Fibrinogen precipitate sediment after the second centrifugation

Figure 4

Preoperative

Figure 5

Application of fibrin glue in the canine and premolar area

Figure 6

The papillae between the second premolar and second molars closed with sutures and papillae between the canine and second premolar closed with fibrin glue

Figure 7

Postoperative 1 week showing better healing in areas closed with fibrin glue compared to sutures. The second molar area which was closed with silk sutures showing erythema