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Which Sutures Work Best with BioXclude?
Polytertrafluaroethylene (PTFE) is the recommeneded suture material. PTFE is non-resorbable, offers persistent tensile strength, and the monofilament construction doesn't allow bacterial wicking into the sit. Unlike other monofilament sutures, it is soft and therefore more comfortable for the patient.


Which Suturing Technique Works Best with BioXclude?
For socket preservation, a reverse figure eight technique is recommended. The "reverse" portion being of high importance, as this inverts the tissue, and aids in membrane retention.

1. DL (White)
2. MB (Blue)
3. ML (Yellow)
4. DB (Green)

Note: The "top" and "bottom" of the "8" run horizontally.



1. DL (White)
2. MB (Blue)
3. ML (Yellow)
4. DB (Green)

Note: The "top" and "bottom" of the "8" run horizontally.


When there is flap elevation, you'll only need BioXclude 1mm under the gingival margin. Allow this technique to approximate the tissue over the membrane, instead of attempting to "tuck" it.

Important note regarding knot tying with PTFE. Some clinicians do not like PTFE because they fee they connot get the knot tight enough. This can be true when attempting a standard surgeon's knot. The knotting sequence must change to allow a slipknot; this will offer a tighter knot with precise tension that you cannot obtain with other suture types.


Suturing
Guide

Reverse or “inverted” sutures pull the tissue both inward and downward. In an open socket this is ideal for membrane retention.

This method also greatly decreases the potential for nicking the membrane.
1
2
3
4
5
6
Figs 1-4: Each pass begins from inside the socket (connective tissue side).
Figs 5-6: The 2-1-1 knot sequence: 2 overhand throws; 1 overhand throw- this is your skipknot. Hold tail and slide other side to desired tension; 1 reverse throw- this locks the knot; continue knotting as desired from this step.


Suturing Guide
Reverse or “inverted” sutures pull the tissue both inward and downward. In an open socket this is ideal for membrane retention.

This method also greatly decreases the potential for nicking the membrane.
Figs 1-4: Each pass begins from inside the socket (connective tissue side).
Figs 5-6: The 2-1-1 knot sequence: 2 overhand throws; 1 overhand throw- this is your skipknot. Hold tail and slide other side to desired tension; 1 reverse throw- this locks the knot; continue knotting as desired from this step.
Does Orientation Matter?
BioXclude has no orientation. During processing, the epithelial layer is removed. This is the distinction between BioXclude and "sister" products like those used in wound care, which are orientation specific. BioXclude's happy smiley face is a reminder it can be placed any which way.

This means it can fold onto itself, be layered and overlap without concern.