290 Theories and techniques of oral implantology

Fig. 7-81. When tissues are particularly thin, buttons may be used to prevent tearing the tissues. (Drawing courtesy Ethicon, Inc.)

for closing the tissues around a protruding implant post (Fig. 7-80) . This gives a tight bond around the post, helping prevent the introduction of microbes and other foreign substances.

There are times when the tissues are extremely weak and ordinary suturing cannot hold them together because they tear easily. The use of auxiliary tension sutures supported by buttons may help pre-vent a continuous suture from tearing (Fig. 7-81) .

Suturing tips. Suturing should be done neatly, smoothly, and in an orderly fashion. The clamps and hemostats should always be placed toward the ends of the suture materials, to avoid disturbing and weakening the sutures that have already been made. Also it is important to maintain traction on the strand to keep the sutures firm and to avoid tangling.

The strands should be pulled gently through and

Fig. 7-82. A, One of the most secure knots and its variations. B, The various methods for knotting the ends of continuous sutures. C, When avoiding a thick knot when using a double thread, one thread may be cut before the last suture. (Drawing courtesy Ethicon, Inc.)