Search Results (30)

Surgical sutures are temporary load-bearing biomaterials whose performance in the oral cavity may be altered by postoperative mouthrinses. Seven USP 4-0 suture materials were immersed in four commercial mouthrinses for 3, 7, 10, and 14 days in a balanced factorial design (n = 3 per condition), with artificial saliva as a time-matched reference. Maximum breaking force (Fmax), apparent wet-state mass change, and solution pH were evaluated, and Day 14 re-dried mass was determined in an additional cohort (n = 5). Fmax was significantly affected by material, mouthrinse, time, and all interaction terms (p < 0.001), with material showing the largest main effect (partial η² = 0.957). Mean Fmax decreased by 57.1% for PGA and 53.3% for PGLA between Days 3 and 14 when averaged across mouthrinses. PGLA also declined in artificial saliva (−49.1%), showing that temporal loss was not exclusive to mouthrinse exposure. Mean apparent wet-state mass change ranged from 85.1% for silk to 8.5% for nylon 66 and showed a weak pooled association with Fmax (r = −0.163, p = 0.086); suture-related pH shifts were small. Under static immersion, response was specific to the material–formulation pair and evolved with time. Continuous immersion without medium renewal or prior salivary conditioning does not reproduce intermittent clinical mouthrinse use. Full article

Peritoneopericardial diaphragmatic hernia (PPDH) is a congenital anomaly allowing communication between the peritoneal and pericardial cavities. Surgical repair of large diaphragmatic defects can be challenging due to insufficient tissue for primary closure. A 2-year-old intact female White Miniature Schnauzer weighing 6.23 kg presented with a 1-month history of panting and exercise intolerance. Thoracic radiography, ultrasonography, echocardiography, and CT confirmed PPDH with herniation of the left medial and quadrate liver lobes into the pericardial sac. Surgical repair via midline celiotomy revealed a large defect (4.5 × 5 cm) involving approximately 70% of the central tendon. Primary closure was incomplete because only two simple interrupted sutures could be placed at the dorsal margin due to excessive tension, leaving a triangular residual defect larger than 3 × 3 cm at the ventral aspect, which was closed with a two-layer canine small intestinal submucosa (cSIS) patch applied over the residual defect. Reherniation occurred 42 days postoperatively at the margin between the diaphragm and the cSIS patch. At the second surgery, grossly observed tissue presumed to be newly formed self-tissue at the cSIS site enabled direct suture repair. No recurrence was observed during a 5-month follow-up, and a telephone interview with the owner 3 years after the second surgery confirmed that the dog remained free of clinical signs. This case suggests that cSIS may serve as a feasible reinforcement biomaterial for large diaphragmatic defects where primary closure alone is insufficient, although conclusions drawn from a single case remain preliminary, and surveillance for marginal reherniation is warranted. Full article

Polyhydroxyalkanoates (PHAs) are a structurally diverse family of microbially synthesised, biodegradable polyesters that accumulate as intracellular carbon and energy reserves under conditions of nutrient imbalance. Their combination of adjustable mechanical performance with controlled hydrolytic and enzymatic degradation, and non-toxic degradation intermediates (ex. D-3-hydroxybutyrate) has made them a longstanding candidate biomaterial for human tissue engineering, drug delivery, and resorbable implants. Comparatively, their application in veterinary medicine remains an emerging and fragmented field, despite an arguably stronger practical case: veterinary practice faces acute pressure to replace non-degradable sutures, orthopaedic hardware, and single-use plastics with materials that avoid secondary retrieval surgery, that can be produced at low cost for large-scale animal use, and that align with growing regulatory and consumer demand for sustainable animal healthcare. This review consolidates current understanding of PHA biosynthesis, covering the core: phaA-phaB-phaC pathway, medium-chain-length variants, microbial producers, feedstock flexibility, and metabolic engineering strategies for yield improvement. It also examines material modification strategies, including blending, chemical grafting, surface functionalisation, electrospinning, and additive manufacturing, used to adapt PHAs for specific veterinary form factors. The clinical and preclinical evidence base is presented in detail across wound management, orthopaedic and soft-tissue regeneration, cardiovascular tissue engineering, drug delivery, and surgical devices, with attention to species-specific considerations in companion animals, horses, and food-producing ruminants. This review relies exclusively on peer-reviewed literature for its quantitative claims, while transparently noting where veterinary-specific data are lacking, extrapolated from rodent or human models, or in need of independent verification. Persistent barriers like production cost, batch-to-batch variability, absence of veterinary-specific regulatory pathways, and limited long-term in vivo safety data in large animals are analysed critically, alongside translational opportunities including waste-feedstock valorisation, hybrid PHA/ceramic and PHA/natural-polymer composites, and stimuli-responsive formulations. We conclude that PHAs are scientifically well positioned but institutionally under-validated for veterinary translation, and we outline a concrete research agenda to close this gap. Full article

Surgical sutures are widely used biomaterials in clinical practice. Like all other biomaterials, they induce a foreign body response after implantation that involves inflammation and angiogenesis. Although it is well known that these processes differ in males and females, sex-specific differences in the tissue response to sutures have not been investigated so far. To do this in the present study, polypropylene sutures were implanted into the dorsal skinfold chamber and subcutaneous flank tissue of male and female mice to assess their acute and chronic effects on the local tissue microenvironment using intravital fluorescence microscopy and immunohistochemistry over 14 and 28 days, respectively. Microhemodynamic parameters and the numbers of rolling and adherent leukocytes in venules next to the implants were comparable in male and female mice. Immunohistochemical analyses on day 14 revealed a stronger neutrophilic (myeloperoxidase (MPO)⁺ cells: 526 ± 29 mm⁻²) and macrophage (CD86⁺ cells: 188 ± 21 mm⁻²; CD163⁺ cells: 269 ± 25 mm⁻²) response, as well as reduced T-cell activation (CD3⁺ cells: 31 ± 4 mm⁻²) in females when compared to males (MPO⁺ cells: 221 ± 25 mm⁻²; CD86⁺ cells: 120 ± 15 mm⁻²; CD163⁺ cells: 101 ± 19 mm⁻²; CD3⁺ cells: 62 ± 13 mm⁻²), while microvessel density and collagen deposition in the forming granulation tissue around the implants did not differ between sexes. In the flank model, there were no detectable sex-specific differences in the chronic foreign body response. These findings demonstrate that polypropylene sutures provoke a stronger early activation of the innate immune system in females, whereas the chronic foreign body response to the implants is comparable in both sexes. Full article

Perioperative management of antithrombotic therapy in oral surgery represents an evolving paradigm. This critical review evaluates the contemporary scientific evidence that challenges the conventional practice of routinely discontinuing anticoagulants and/or antiplatelet agents to prevent postoperative bleeding. The traditional strategy carries an unacceptable risk of iatrogenic, sometimes severe, thromboembolic events. The aim of this systematic narrative review is to synthesize the current evidence (2015–2025) and to outline a new, patient-centered clinical framework that dynamically balances thromboembolic and hemorrhagic risks. Materials and methods: A systematic search of major databases (PubMed/MEDLINE, Scopus, Web of Science) identified relevant studies, structured according to the PICO framework. The search strategy prioritized high-level evidence, including clinical guidelines, systematic reviews, meta-analyses, randomized controlled trials, and prospective cohort studies published between January 2015 and November 2025. Results: The results reinforce an emerging consensus: the basis of safe management is the rigorous application of advanced local hemostasis techniques (e.g., prioritizing resorbable materials, sutures, topical hemostatic agents, and antifibrinolytics) and the use of perioperative decision-making algorithms. These measures allow, in most routine dental surgical procedures, the safe continuation of antithrombotic therapy, thus minimizing the thromboembolic risk without significantly increasing the risk of clinically significant bleeding. In the future, research should focus on optimizing materials science (novel biomaterials and controlled-release systems) and on standardizing and validating protocols in specific populations (e.g., patients on combination therapy or at extreme cardiovascular risk). This review argues that the adoption of this evidence-based model, with local hemostasis as a critical pillar, is essential for modern, ethical, and safe dental practice. Full article

Background: Necrotizing enterocolitis (NEC) is a life-threatening condition characterized by necrosis of the gastrointestinal tract caused by hypoperfusion and hypoxia-induced inflammation. Surgical treatment often requires resection, with high morbidity and mortality. Intestinal tissue engineering using absorbable biomaterials represents a potential alternative. Small intestinal submucosa (SIS) is a biodegradable extracellular matrix (ECM) scaffold that may facilitate regeneration of the native tissue. Objectives: The aim of our study is to investigate the regenerative potential of SIS in a rat model with multiple gastrointestinal defects. Methods: In rats, after a midline laparotomy, an approximately 1 cm full-thickness incision was performed on the anterior gastric wall, on the antimesenteric side of the small and large intestine, each covered with an SIS patch. After three weeks, the graft sites and adjacent fragments were harvested and fixed in 10% neutral buffered formalin. Cross-sections of the grafted area were processed and stained with hematoxylin and eosin for histologic analysis. Results: Among the fifteen Wistar rats used in the study, the survival rate was 80% (12/15). Macroscopic examination of the abdominal cavity after the second surgery showed no complications. Adhesions were present in 92% (11/12). Histological examination demonstrated complete mucosal coverage in all stomach samples, nine of the small intestine, and ten of the large intestine. Mild fibrosis with minimal inflammatory infiltrates predominated. Ulceration with granulation tissue replacement was observed in three small intestine samples. Foreign body reactions were restricted to suture sites. Conclusions: In this multifocal injury model, SIS integrated effectively and supported early regenerative healing across gastric, small-intestinal, and colonic sites at 3 weeks. These data support further studies with longer follow-up, quantitative histology and functional assessment, and evaluation in neonatal-relevant large animal models to determine translational potential for NEC surgery. Full article

Zone II flexor digitorum profundus (FDP) tendon injuries are complex, and present significant challenges in hand surgery, due to the need to balance strength and flexibility during repair. Traditional suture techniques often lead to complications such as adhesions or tendon rupture, prompting the exploration of novel strategies to improve outcomes. This review investigates the use of flexor digitorum superficialis (FDS) tendon autografts to reinforce FDP repairs, alongside the integration of biomaterials to enhance mechanical strength without sacrificing FDS tissue. Key biomaterials, including collagen–polycaprolactone (PCL) composites, are evaluated for their biocompatibility, mechanical integrity, and controlled degradation properties. Collagen-PCL emerges as a leading candidate, offering the potential to reduce adhesions and promote tendon healing. Although nanomaterials such as nanofibers and nanoparticles show promise in preventing adhesions and supporting cellular proliferation, their application remains limited by manufacturing challenges. By combining advanced repair techniques with biomaterials like collagen-PCL, this approach aims to improve surgical outcomes and minimize complications. Future research will focus on validating these findings in biological models, assessing tendon healing through imaging, and comparing the cost-effectiveness of biomaterial-enhanced repairs with traditional methods. This review underscores the potential for biomaterial-based approaches to transform FDP tendon repair. Full article

Background/Objectives: Autogenous palatal free gingival graft (FGG) harvesting presents challenges for patients due to the increased risk of postoperative morbidity related to a second intraoral surgical wound that heals with secondary intention. This parallel-group, randomized, controlled, open-label trial aimed to evaluate the efficacy of the application of leukocyte- and platelet-rich fibrin (L-PRF) membrane to the palatal donor site on wound healing, hemostasis, and pain control after FGG harvesting. Methods: Twenty-eight adult patients with insufficient attached gingiva underwent soft tissue augmentation using FGG harvested from the palate at the Department of Oral and Maxillofacial Surgery, Baskent University, Turkey. Patients were randomized to either an L-PRF group or a control group. In the L-PRF group, the L-PRF membrane was sutured to the donor sites, whereas in the control group, donor sites healed by secondary intention. Postoperative evaluations were conducted on days 1, 3, 5, and 7 and at weeks 2, 3, 4, 5, and 6. Donor sites were evaluated clinically for pain, burning sensation, bleeding, wound healing, and color match to adjacent tissues. Donor site wound areas were analyzed using digital images. Results: Two patients were excluded from the analysis due to loss of contact, leaving 26 (n = 13, n = 13) patients for analysis. Donor site pain and burning sensation were significantly lower in the L-PRF group compared to the control group during the first two postoperative weeks (p < 0.001). Bleeding was significantly lower in the L-PRF group on postoperative days 1 and 3 (p < 0.001). Clinical healing index scores were significantly higher in the L-PRF group at weeks 3 and 4 (p < 0.001). Additionally, palatal wound area reductions from baseline were significantly greater in the L-PRF group at all follow-up intervals (p < 0.001). Conclusions: The application of an L-PRF membrane to palatal donor wounds after FGG harvesting significantly reduces postoperative pain, decreases bleeding, and accelerates healing, providing a valuable autologous biomaterial for enhanced wound healing and improved patient comfort. Full article

Regenerated cellulose fibers are a highly adaptable biomaterial with numerous medical applications owing to their inherent biocompatibility, biodegradability, and robust mechanical properties. In the domain of wound care, regenerated cellulose fibers facilitate a moist environment conducive to healing, minimize infection risk, and adapt to wound topographies, making it ideal for different types of dressings. In tissue engineering, cellulose scaffolds provide a matrix for cell attachment and proliferation, supporting the development of artificial skin, cartilage, and other tissues. Furthermore, regenerated cellulose fibers, used as absorbable sutures, degrade within the body, eliminating the need for removal and proving advantageous for internal suturing. The medical textile industry relies heavily on regenerated cellulose fibers because of their unique properties that make them suitable for various applications, including wound care, surgical garments, and diagnostic materials. Regenerated cellulose fibers are produced by dissolving cellulose from natural sources and reconstituting it into fiber form, which can be customized for specific medical uses. This paper will explore the various types, properties, and applications of regenerated cellulose fibers in medical contexts, alongside an examination of its manufacturing processes and technologies, as well as associated challenges. Full article

Sutures are natural or synthetic biomaterials utilized to hold tissues together. Following oral surgery, the surgical site and sutures are physically affected by many different factors. This study was conducted to evaluate the effect of artificial saliva (AS) and chlorhexidine mouthwash on the tensile strength of absorbable multifilament PGLA (polyglycolide-co-l-lactide) and non-absorbable multifilament silk sutures. PGLA and silk sutures, which are commonly used in oral surgery, were used to evaluate the change in strength of the sutures. A total of 352 suture samples were divided into eight equal groups (n = 44) and used for the experiments. Tensile strength was tested on days 0, 3, 7, and 14. For the silk sutures, there was a significant decrease in tensile strength in all groups at time T3 compared to T0, T1, and T2, and at times T1 and T2 compared to T0. For PGLA sutures, there was a significant decrease in all groups at time T3 compared to T0, T1, and T2. This study shows that chlorhexidine mouthwash significantly reduces suture resistance for 14 days after surgery. Full article

Suture materials are natural or synthetic biomaterials used to close tissues together. After surgical procedures in the mouth, the surgical site and the sutures are physically affected by many different factors. This study was conducted to evaluate the effects of frequently consumed beverages on the tensile strength of monofilament PGLA (polyglycolide-co-l-lactide) and multi-filament PGCL (polyglycolide-co-caprolactone) absorbable sutures. In particular, PGLA and PGCL absorbable sutures, which are frequently used in oral surgery, were used to evaluate the change in the strength of suture materials. The suture materials were soaked in tea, coffee, and cola drinks five times a day for 5 min each and the rest of the time in artificial saliva. All suture materials were aged via thermal cycling. Tensile strengths were tested at 0, 3, 7, and 14 days. Mixed ANOVA (four replicates: within-group comparison and two factors: between-group comparison) was performed to evaluate the effects of groups and time on the tension levels of the Tekmon and Vicryl suture materials. Analysis of Variance was used for the within- and between-group comparisons, with the Bonferroni corrected t-test for multiple comparisons. For the PGCL suture material, there were significant decreases in tension levels in artificial saliva, tea, coffee, and cola at time T3 compared to T0, T1, and T2, and at T1 and T2 compared to T0. For the PGLA suture material, there were significant decreases in tension levels in artificial saliva, tea, coffee, and cola at time T3 compared to T0, T1, and T2. There was also a significant decrease in tension level at time T2 in cola compared to T0. The present study demonstrates that beverages significantly decrease the strength of suture materials for 14 days after surgery. In particular, cola decreased the resistance of the PGCL suture material more significantly in the first week when compared to other beverages. Full article

Linear polyamides, known as nylons, are a class of synthetic polymers with a wide range of applications due to their outstanding properties, such as chemical and thermal resistance or mechanical strength. These polymers have been used in various fields: from common and domestic applications, such as socks and fishing nets, to industrial gears or water purification membranes. By their durability, flexibility and wear resistance, nylons are now being used in addictive manufacturing technology as a good material choice to produce sophisticated devices with precise and complex geometric shapes. Furthermore, the emergence of triboelectric nanogenerators and the development of biomaterials have highlighted the versatility and utility of these materials. Due to their ability to enhance triboelectric performance and the range of applications, nylons show a potential use as tribo-positive materials. Because of the easy control of their shape, they can be subsequently integrated into nanogenerators. The use of nylons has also extended into the field of biomaterials, where their biocompatibility, mechanical strength and versatility have paved the way for groundbreaking advances in medical devices as dental implants, catheters and non-absorbable surgical sutures. By means of 3D bioprinting, nylons have been used to develop scaffolds, joint implants and drug carriers with tailored properties for various biomedical applications. The present paper aims to collect evidence of these recently specific applications of nylons by reviewing the literature produced in recent decades, with a special focus on the newer technologies in the field of energy harvesting and biomedicine. Full article

Introduction: Although various surgical techniques have been utilized in the reconstruction of severely resorbed alveolar bone, its regeneration is still regarded as a major challenge. Most of the surgical techniques used in advanced ridge augmentation have the disadvantages of prolonging the patient’s edentulous healing and increasing the need for surgical revisits because simultaneous implant placement is not allowed. This report presents a new and simplified method for advanced ridge augmentation, which utilizes a vertical tenting device. Case Presentation: The first case presented the reconstruction of the mandibular posterior region with severely resorbed alveolar bone due to peri-implantitis using tenting pole abutment for ridge augmentation. The second and third cases presented three-dimensional ridge augmentations in severely resorbed ridges due to periodontitis. The last case presented horizontal ridge augmentation using a vertical tenting device. All cases were performed under local anesthesia. Implants were simultaneously placed in the bone defect area. A vertical tensioning device was then connected to the implant platform to minimize the collapse of the bone graft during the bone regeneration period due to the contraction of the soft tissue matrix. A sticky bone graft was transplanted onto the exposed surface of the implant and on top of the vertical tensioning device. After covering with an absorbable barrier membrane, the soft tissues were sutured without tension. Conclusions: In all cases, prosthetic restorations were provided to patients after a bone grafting period of 5–6 months, leading to a rapid restoration of masticatory function. Results tracked for up to 6 years revealed observed stable reconstruction of the alveolar bone. The use of a vertical tenting device can prevent the collapse of biomaterials in the augmented ridge during the healing period, leading to predictable outcomes when achieving three-dimensional ridge augmentation. Full article

Torn and damaged menisci resulting from trauma are very common knee injuries, which can cause pain and mobility limitations and lead to osteoarthritis. Meniscal injuries can require surgery to repair the tissue damage and restore mobility. Here we describe the biomechanical testing of a 3D-printed meniscus to illustrate methods to determine if it has the strength and durability to effectively repair meniscal tears and restore knee biomechanics. This work was designed to demonstrate the steps needed to test novel meniscus repair devices prior to moving toward animal testing. The first testing step determined the ability of the 3D-printed meniscus to withstand surgical fixation by measuring the suture pull-out force. We show that vertical 2/0 silk or Fiberwire sutures need an average of 1.4 or 1.8 N, respectively, to pull through the meniscus, while horizontal sutures need only 0.7 and 1.2 N, respectively. The next step measured the compressive strength of normal, damaged, and repaired porcine meniscus tissue. Here, we show that meniscectomy decreased the stiffness of meniscus tissue from 26.7 ± 0.85 N to 7.43 ± 0.81 N at 25% strain. Menisci repaired with the 3D-printed tissue restored 66% of the measured force at 25% strain. The final step measured the contact pressures and areas in an ex vivo porcine knee before and after meniscal repair was made with the 3D-printed meniscus tissue. The example 3D-printed meniscus was successfully sutured into the porcine knee joint but failed to restore normal knee contact pressures. This work demonstrates the need for an iterative biomechanical testing process of biomaterial development, 3D-printing optimization, and knee kinematics to develop a durable and functional meniscus repair device. In summary, the methods described here serve as a guide for the functional evaluation of novel meniscus repair devices. Full article

In the past decades, there has been a significant increase in the use of polymers for biomedical applications. The global medical polymer market size was valued at USD 19.92 billion in 2022 and is expected to grow at a CAGR of 8.0% from 2023 to 2030 despite some limitations, such as cost (financial limitation), strength compared to metal plates for bone fracture, design optimization and incorporation of reinforcement. Recently, this increase has been more pronounced due to important advances in synthesis and modification techniques for the design of novel biomaterials and their behavior in vitro and in vivo. Also, modern medicine allows the use of less invasive surgeries and faster surgical sutures. Besides their use in the human body, polymer biomedical materials must have desired physical, chemical, biological, biomechanical, and degradation properties. This review summarizes the use of polymers for biomedical applications, mainly focusing on hard and soft tissues, prosthetic limbs, dental applications, and bone fracture repair. The main properties, gaps, and trends are discussed. Full article