# Evaluation of the Effect of Polybutester and Polypropylene
## 4 Discussion
Histologic analysis showed more inflammation in multifilament sutures. Microbial analysis showed less microbial attachment in monofilament sutures. In clinical analysis, it was observed that synthetic materials were more successful in wound healing than natural materials. It has been shown that pain during suture removal occurs more in multifilament sutures than in monofilament sutures. It was stated by the physician that the most comfortable suture was monofilament Surgipro(r) and the most difficult suture was multifilament Sofsilk(r). It was reported that the least discomfort caused by the sutures was found in Caprosyn(r) [25]. In a study by [PERSON] et al. on the bacterial adhesion of suture materials in the mouth, they compared silk, nylon, polyester and poligelcaprone 25 suture materials in 60 patients who underwent periodontal surgery. The researchers found that silk showed the highest bacterial adhesion and the resolvable suture material poligelcaprone 25 (Monocry) showed less bacterial adhesion than silk. They found that twice as many anaerobic bacteria grew on unresorbable sutures than on resorbable sutures [26]. In their study investigating the capillarity properties of suture materials and bacterial transmission, [PERSON] et al. added a coloring agent to the medium to examine fluid transmission and bacteria to examine bacterial transmission in sutures kept in a closed and sterile environment. According to the results of the study, a certain amount of colorant and bacterial migration was detected in all multifilament suture materials, and they reported that this migration was independent of the absorption capacity of the suture materials, coating and the presence of open suture ends [27]. [PERSON] et al. examined the tissue reaction of flexible polytetrafluoroethylene (ePTFE) and silk sutures on the oral mucosa in a study on greyhounds and applied antibiotics or mouthwash in addition to the sutures. The mucoperiosteal flaps around the mandibular premolars of greyhounds were lifted, repositioned and sutured with two different materials on the opposite jaws. Biopsies were evaluated for inflammatory cells, epithelial cells, fibroblasts and bacterial plaques around the sutures. According to the results obtained, bacterial plaque invasion was observed at a rate of six out of nine for silk sutures and zero out of nine for ePTFE in the antibiotic group and six out of six for silk sutures and three out of six for ePTFE sutures in the mouthwash group [28]. In a study examining the tissue reactions of polyglactin 910, poligelcaprone 25 and polytetrafluoroethylene (PTFE) suture materials in Wistar albino rats, fibrosis, angioplasty and fibrobl polarizations, and inflammation intensities were evaluated histologically on the 2 nd, 7 th, 14 th and 21 st days by optical microscopy. According to the results of the study, the frequency of tissue reaction was found to be in the following order: polilecaprone 25, polyglactin 910 and polytetrafluoroethylene [29]. When the studies were evaluated in general, it was observed that monofilament sutures caused less tissue reaction and inflammation than multifilament sutures. Multifilament sutures were generally found to have less physical strength and more bacterial adhesion. However, dissolvable multifilament sutures were generally better tolerated by patients than other sutures. Silk sutures, which are frequently used in oral surgical procedures, were found to be unsuccessful compared to other sutures in terms of bacterial retention, pain during suture removal, tissue reaction and inflammation. The reason for choosing two different monofilament sutures in this study is that monofilament sutures are superior in terms of their physical and biological properties (wound healing, tissue reaction and inflammation), as seen in the results of the mentioned studies. When the studies using PP sutures were examined, [PERSON] et al. evaluated the soft tissue reaction of different suture materials in their study on Sprague-Dawley rats.