Re: Suture Questions and Concerns

Steven Bornfeld wrote:
Pete wrote:
Steven Bornfeld wrote:
It's very likely some stitches have fallen out. If not, it will
almost certainly be easy to remove any remaining with direct vision
and bright light.

Steve

Thanks Steve...but how would they fall out, if they are a strong
synthetic thread. And like I said there is no sign of any thread
left at all, anywhere, so doesn't that mean the dentist will have to
dig for them, and upset my surgery. I really don't see anything at
all, looking very closely with a bright flashlight, flashing
directly on the area (they are gone). Is it possible the dentist botched
the job somehow. I was hoping
for a more detailed answer (ie do stitches normally get buried after
a few days or not - and if not I don't see how he will be able to remove
them if
they are not visible). Sorry for the repetition, but this doesn't
sound right to me. I have had several stitches removed on bodily
cuts in my life, and the stitches are always visible.

Thanks...Pete




Obviously I have no way of knowing what suture material was used. I
use mostly silk because it's easy to use. Synthetic materials usually
require more knots, and when I've used them they're a little more
difficult to tie without tearing the tissue. However, sometimes they
provoke less tissue reaction, so there is good reason to use them,
and I don't do much surgery in any case.
The mouth is a difficult place to retain sutures--unless it is covered
by a dressing, think of all the stuff rubbing up against them--food,
tongue, etc. Anywhere else on the body the sutures would probably be
covered by a bandage for a few days, and you wouldn't get the surgical
wound wet. I can tell you that within a week of suturing, I can count
on about 1/3 or the sutures I've placed to have come out by
themselves. On the plus side, the soft tissue of the mouth heals
wonderfully
almost always--in a wet, septic environment. Specifically to your
situation, you didn't say if the torus removal was on the palate or the
lower
jaw. The tissue is usually very thin around these, and prone to
breakdown. In this case you'll get a whitish-greyish fibrin
pseudomembrane covering the area, and it will eventually granulate in.
There is
nothing in your description to make me think your surgeon "botched"
anything, but by all means have him/her look at it to make sure the
healing is OK. I'm guessing it is--but if there is increased swelling
after 48 hours or any drainage from the area for sure get it checked
sooner. This tissue--as thin as it is--you shouldn't have any worries
about sutures getting "lost".

Steve

Thanks Steve...I don't know if he used synthetic thread (I just used that
term). The thread seemed relatively thick, and dark color. The torus was
in my lower left jaw, all the way in the back. I had the second molar
extracted (same lower left jaw) a couple months ago by my regular dentist,
and had a lot of trouble afterwards with bone chips in the adjacent torus
(lingual side), which kind of caved in after he picked a chunk of bone chip
out with his dental pick a couple weeks later. I went back to him twice,
and the first time he said everything was okay (NOT), and then I started
draining a lot of pus through the torus and went back to him again, after a
round of Pen-Vee K didn't help, and that is when he picked out the chunk of
bone. I thought for sure it would be okay then, but not with my luck.

The torus I just had surgery on (by the new dentist) is all the way back (in
the wisdom area next to the second molar I just had pulled, lower left jaw -
I have no wisdom tooth there). The previous extraction impacted that torus
also, and it was bothering me, so I went to the new dentist I mentioned that
does laser implants, and is more like an oral surgeon, even though he is not
an oral surgeon.

I have a large amount of the white membrane you mention on the lingual side
where he used the laser and the osteotomy drill to cut the tissue, and knock
down the boney projection. I could clearly see the sutures right after the
surgery - now all I see is white membrane, and the knot at the top is gone
also. I still don't see how a strong thread can come loose unless they are
just laying in there in some kind of half ass fashion. I guess it may
depend on the skill of the surgeon also - dunno.

You said the sutures shouldn't get lost. But how will he find them without
digging in with a dental pick or some other sharp tool. This is what
bothers me and is what I am concerned about. Also I don't know how many
stitches he did, versus being continuous - I'll have to ask him. He is 53
years old, and very experienced, and like I said, he travels all over the
world teaching the waterlase stuff.

My main question is how will he find the stitches without digging in with a
pointed tool and disrupting my surgery. Is it possible that the stitches
are truly gone and no longer there, and if that is the case, could that mean
that he may not be proficient at stitching (he was awesome at injecting the
prilocaine - went really slow and I couldn't feel anything - I praised him
highly for that).

I am not asking you to bad mouth him, I am just trying to find out what the
norm is. If the dentist can't do stitches right - I may have to reconsider
having him doing a laser assisted implant on me - since that will also
involve stitching :-) . I just joined the group today, and have read some
bad things in here about implants, so now I am wondering if it's worth the
risk. Right now I have no molars on my lower left side and that is not a
good thing to be chewing on one side for the rest of my life. The off
center forces will mess up my jaw, and needless to say cause premature
failure of the teeth on the other side, which already has two crowns, with a
root canal through one of them. I am 60 years old. Sorry for rambling.

Thanks again for your help...Pete

PS - I am very impressed with this newsgroup, and it is so refreshing to see
all the dentists volunteering their time. It is rare to see that with your
counterparts, the medical doctors (ie MD's). Thank you to all of you, and
please continue to volunteer your time if you can. It is greatly
appreciated.


.

Relevant Pages

  • Re: Suture Questions and Concerns
    ... I have had several stitches removed on bodily ... The torus was in my lower left jaw, all the way in the back. ... The previous extraction impacted that torus also, and it was bothering me, so I went to the new dentist I mentioned that does laser implants, and is more like an oral surgeon, even though he is not an oral surgeon. ... Clearly for many dentists it's an attempt to distinguish themselves from the crowd in a very competitive field. ...
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