Cyanoacrylate Glue in Modern Dentistry: A Faster, Gentler Way to Support Healing?
A New Look at Dental Wound Closure
In oral surgery and periodontology, sutures have long been the gold standard for closing wounds and stabilizing grafts. But as dentistry moves toward less invasive and more patient-friendly approaches, alternatives like cyanoacrylate tissue adhesives essentially medical-grade “super glue” are gaining attention.
A new scoping review published in Medicina (2025) compiles evidence from randomized clinical trials over the last decade to evaluate how well these adhesives actually work inside the mouth. The findings indicate that cyanoacrylates may offer meaningful benefits in specific procedures especially when it comes to reducing pain, shortening procedure time, and supporting early wound healing.
Why Cyanoacrylates Matter
Cyanoacrylates polymerize within seconds when in contact with moisture, forming a protective film that seals tissue edges. Unlike sutures, which can cause minor trauma, tension, or inflammation, tissue adhesives:
Bond quickly
Don’t need removal
Provide inherent hemostasis (help stop bleeding)
Show antimicrobial activity
Allow shorter chair-side time
Long-chain cyanoacrylates like n-butyl and 2-octyl versions are especially favored because they degrade more slowly and exhibit lower toxicity.
What the Researchers Did
The authors searched PubMed, Scopus, and Web of Science for randomized controlled trials published from 2015 to 2025.
From 1728 initial articles, they ultimately included 19 high-quality clinical trials exploring cyanoacrylate use in:
Free gingival graft stabilization
Palatal donor-site wound management
Periodontal flap closure
Mandibular third-molar surgery
Socket sealing for ridge preservation
Alveoloplasty
Stage II implant recovery
This broad scope allowed the authors to examine where cyanoacrylates excel, where they perform similarly to sutures, and where limitations remain.
Where Cyanoacrylates Show Strong Advantages
1. Free Gingival Graft (FGG) Stabilization
Studies show that CA adhesives can:
Reduce graft shrinkage
Improve early healing scores
Shorten pain duration
In one trial, patients experienced 1 day less postoperative pain compared to sutures. The adhesive produced stable graft fixation without compromising long-term outcomes.
2. Palatal Donor-Site Healing
This is where cyanoacrylates shine the most.
Across several trials, CA application sometimes combined with collagen sponges or platelet-rich fibrin consistently led to:
Reduced pain for up to 14 days
Less bleeding
Faster early healing
Lower analgesic consumption
Shorter application time (as short as ~2 minutes vs. ~8 minutes for sutures)
Some studies found that combining CA with a gelatin or collagen sponge gave the best patient comfort overall.
3. Periodontal Flap Surgery
Findings are mixed but promising:
Many trials showed better early healing, less pain, and reduced plaque accumulation in the first postoperative week.
Antimicrobial properties of cyanoacrylates helped lower levels of Porphyromonas gingivalis a major periodontal pathogen.
Other studies found no statistically significant differences, though CA still reduced the need for analgesics.
Overall, cyanoacrylates appear to be a reliable alternative when sutures are uncomfortable or follow-up visits are difficult.
Where Cyanoacrylates Perform Similarly to Sutures
Third Molar (Wisdom Tooth) Surgery
Two well-designed trials found:
No major differences in pain, swelling, trismus, or healing
A notable benefit: less bleeding on the first postoperative day for CA-treated sites
Thus, CA is safe and effective, but not dramatically superior.
Emerging Uses: Ridge Preservation, Alveoloplasty, and Implant Surgery
Alveolar Ridge Preservation
Compared to collagen membranes, cyanoacrylates showed:
Less buccolingual ridge resorption
Lower marginal bone loss
Fewer cases of membrane exposure
This suggests potential for better preservation of bone architecture after extraction.
Alveoloplasty and Implant Stage II Recovery
Trials reported:
Faster wound closure
Quicker hemostasis
Reduced early postoperative pain
Comparable or better healing by day 7
This positions CA as a time-saving, patient-friendly alternative during pre-prosthetic and implant procedures.
Safety and Limitations
While long-chain cyanoacrylates are generally safe, the review highlights:
Short-chain versions can be cytotoxic
Rare hypersensitivity or irritation may occur
Formaldehyde release during degradation is a theoretical concern
Not all clinical outcomes are superior sometimes CA matches, rather than exceeds, sutures
Sample sizes across studies are often small
Long-term follow-up data remain limited
What This Means for Clinical Practice
Cyanoacrylate tissue adhesives are not a universal replacement for sutures, but they are a powerful tool in several dental procedures especially:
Free gingival grafts
Palatal wound management
Alveoloplasty
Certain periodontal surgeries
Soft-tissue closure in implant procedures
They offer faster procedures, less pain, and good healing, making them attractive for clinicians aiming to improve patient comfort and efficiency.
Conclusion
This scoping review confirms that cyanoacrylates represent a valid, safe, and often advantageous alternative to sutures across various oral surgical contexts. Their benefits are clearest in procedures involving grafts and donor sites, where they consistently reduce discomfort and accelerate healing.
However, more standardized, large-scale clinical trials are needed—particularly to clarify long-term outcomes and refine guidelines for when CA should be preferred over traditional sutures.
Original Article
Gerardi, D., Burdo, P., Turkyilmaz, I., Diomede, F., Mendes, G.D., Piattelli, M., & Varvara, G. (2025).
Clinical Applications and Efficacy of Cyanoacrylates in Oral Surgery and Periodontology: A Scoping Review.
Medicina, 61(7), 1286.
DOI: 10.3390/medicina61071286