Effect of Selected Mouthwashes on Tensile Strength of Absorbable Sutures

Objectives: The present in vitro study aimed to determine the effect of artificial saliva, two common commercial mouthwashes and the non-immersed dry condition on tensile strength and breaking load of two absorbable intraoral sutures; polyglactin 910 (Vicryl^®) and poliglecaprone 25 (Monocryl^®).
Methods: Two commonly used absorbable sutures (Vicryl^® and Monocryl^®) were used in 4-0 and 5-0 gauges. After pre-tensioning, 400 suture samples (100 of each type and gauge) were immersed in three thermostatically controlled experimental media to simulate daily oral rinsing activity, namely —artificial saliva, 0.02% chlorhexidine gluconate (Parodontax^® extra) and essential oils based rinse (Listerine^® Zero™). Non-immersed sutures were used as positive control. Proper pH level and temperature of 37°C were all maintained. Tensile strength was assessed 1, 3, 7, 10 and 14 days post immersion using universal Instron^® testing machine. The maximum load required for suture breakage was determined, and the location of breakage was also assessed.
Results: Vicryl^® suture materials showed significant reduction in the tensile strength for dry 4-0 sutures in comparison with other media. However, there was no significant difference in tensile strength in all four media during the experiment. Meanwhile, tensile strength of 5-0 sutures had a significant rise in tensile strength after soaking in chlorhexidine and Listerine^®, when compared to dry and saliva. On the other hand, Monocryl^® 4-0 suture materials demonstrated a reduction in the tensile strength overtime, without significant difference between dry and other media. Similarly, 5-0 sutures had no significant change between chlorhexidine, saliva and dry media. Nevertheless, Listerine^® resulted in a significant drop in the tensile strength.
Conclusions: Based on our results, Listerine^® mouthwash may not be preferred when using Monocryl^® 5-0. With Vicryl^® sutures however, the use of chlorhexidine and Listerine^® mouthwashes is recommended. Properly designed clinical studies are necessary to confirm the findings of this study.