Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons · 2026
Cyanoacrylate Tissue Adhesives in Oral and Maxillofacial Surgery: A Narrative Review of Clinical Outcomes.
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Pinto Alessandro, Mazzetti Vincenzo, Giordano Francesco, Carosi Paolo, Lorenzi Claudia
Аннотация
BACKGROUND: Cyanoacrylate tissue adhesives have been proposed as an alternative to conventional suturing for wound closure in oral and maxillofacial surgery. This narrative review summarizes the available clinical evidence on their use in oral and maxillofacial surgical procedures, focusing on operative efficiency, wound healing, and postoperative outcomes. The purpose of this work is to evaluate the clinical efficacy and safety of cyanoacrylate tissue adhesives as an alternative to conventional suturing in oral and maxillofacial surgical procedures.
FINDINGS: Six clinical studies involving 302 subjects were included. Only 29 of these subjects (in 2 split-mouth trials) underwent an intrapatient comparison of both techniques; the remaining studies compared separate groups across heterogeneous procedures. Across different surgical settings, cyanoacrylate tissue adhesives were associated with reduced operative time; in the studies reporting quantitative data, closure time decreased from 7.31 to 2.16 minutes, from 355.4 to 191.9 seconds, and from 18.7 ± 1.66 to 6.3 ± 0.73 minutes. Early wound stabilization and hemostasis appeared favorable in selected procedures. One study reported higher day 1 hemostasis with cyanoacrylate than with sutures (70.0 vs 43.4%). Long-term soft tissue outcomes were generally comparable to conventional sutures; in one trial, 6-month graft shrinkage was 19.08 ± 4.78 mm2 with cyanoacrylate and 16.83 ± 4.84 mm2 with sutures, with no significant difference (P = .264). Postoperative pain outcomes were variable across studies, and no serious systemic adverse events were reported.
CONCLUSIONS AND RELEVANCE: Cyanoacrylate tissue adhesives may offer some clinical advantages over conventional sutures in selected oral and maxillofacial surgical procedures, particularly in terms of operative time and early wound stabilization. Nevertheless, long-term outcomes appear broadly comparable, and the available evidence is limited by heterogeneity and inconsistent outcome reporting. Because the included procedures were heterogeneous and only a small subset allowed direct intrapatient comparison, these findings should be interpreted as descriptive clinical trends rather than evidence of superiority, and cyanoacrylate should be regarded as a complementary tool rather than a universal replacement for sutures.
FINDINGS: Six clinical studies involving 302 subjects were included. Only 29 of these subjects (in 2 split-mouth trials) underwent an intrapatient comparison of both techniques; the remaining studies compared separate groups across heterogeneous procedures. Across different surgical settings, cyanoacrylate tissue adhesives were associated with reduced operative time; in the studies reporting quantitative data, closure time decreased from 7.31 to 2.16 minutes, from 355.4 to 191.9 seconds, and from 18.7 ± 1.66 to 6.3 ± 0.73 minutes. Early wound stabilization and hemostasis appeared favorable in selected procedures. One study reported higher day 1 hemostasis with cyanoacrylate than with sutures (70.0 vs 43.4%). Long-term soft tissue outcomes were generally comparable to conventional sutures; in one trial, 6-month graft shrinkage was 19.08 ± 4.78 mm2 with cyanoacrylate and 16.83 ± 4.84 mm2 with sutures, with no significant difference (P = .264). Postoperative pain outcomes were variable across studies, and no serious systemic adverse events were reported.
CONCLUSIONS AND RELEVANCE: Cyanoacrylate tissue adhesives may offer some clinical advantages over conventional sutures in selected oral and maxillofacial surgical procedures, particularly in terms of operative time and early wound stabilization. Nevertheless, long-term outcomes appear broadly comparable, and the available evidence is limited by heterogeneity and inconsistent outcome reporting. Because the included procedures were heterogeneous and only a small subset allowed direct intrapatient comparison, these findings should be interpreted as descriptive clinical trends rather than evidence of superiority, and cyanoacrylate should be regarded as a complementary tool rather than a universal replacement for sutures.