{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T16:15:35Z","timestamp":1788279335822,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T00:00:00Z","timestamp":1777161600000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical &amp;amp; Exp Dental Res"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Clinician expertise influences approach choices, amidst ongoing research on suturing techniques\u2019 biomechanical effects on graft stability. This study evaluated different suturing methods and cyanoacrylate adhesive for FGG fixation with a porcine mandible model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>Ninety\u2010four FGG procedures were performed on juvenile pig mandibles. Eight fixation methods were evaluated: seven suturing techniques\u2014Cross Compression (CC), Vertical Circumferential Compression (VCC), Horizontal (H), CC\u2009+\u2009H, VCC\u2009+\u2009H, Miller (MIL), Holbrook and Ochsenbein (Chan et al.)\u2014and cyanoacrylate adhesive (GLU). Outcomes measured included marginal tension (vertical displacement force) and lateral tension (horizontal displacement) at the graft margin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The HOC technique demonstrated the highest marginal stability (3.82 (SD 1.35\u2009N) and compressive resistance (0.76 (SD 0.48\u2009N). CC\u2009+\u2009H and VCC\u2009+\u2009H also showed significantly enhanced marginal stability. Compared to MIL, HOC exhibited superior compressive resistance (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), while both HOC and CC\u2009+\u2009H achieved significantly greater marginal tension (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Graft dimensions influenced outcomes: greater graft height improved compressive resistance, while increased length reduced marginal stability with horizontal sutures. Mean suturing time was 4.84\u2009min (SD 1.55); CC was faster than MIL (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), whereas HOC, CC\u2009+\u2009H, and VCC\u2009+\u2009H required significantly more time (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). GLU achieved marginal stability (3.45 (SD 3.2\u2009N) comparable to HOC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Within the limitations of this ex vivo study, suturing technique and graft dimensions significantly affect the FGG's biomechanical stability. Holbrook and Ochsenbein's suturing technique achieved the highest marginal stability and compressive resistance. Furthermore, tissue adhesive demonstrated comparable performance to conventional sutures, supporting its potential as an alternative fixation method.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cre2.70345","type":"journal-article","created":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T17:42:18Z","timestamp":1777225338000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Suturing and Adhesive Fixation on Free Gingival Graft Stability: An Ex\u2010Vivo Porcine\u2010Model Study"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4305-1353","authenticated-orcid":false,"given":"Kevimy","family":"Agossa","sequence":"first","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA"},{"name":"Univ. Lille, CHU Lille, U1008 \u2010 Advanced Drug Delivery Systems Department of Periodontology School of Dentistry Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3842-6150","authenticated-orcid":false,"given":"Khushboo","family":"Kalani","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8362-3208","authenticated-orcid":false,"given":"Parham","family":"Hazrati","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2025-521X","authenticated-orcid":false,"given":"Chi\u2010Fan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9438-3784","authenticated-orcid":false,"given":"Chen\u2010Lin","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2231-8741","authenticated-orcid":false,"given":"Dumitru","family":"Chele","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA"},{"name":"Oro\u2010maxillo\u2010facial Surgery and Oral Implantology Department State University of Medicine and Pharmacy \u201cNicolae Testemitanu\u201d Chisinau Republic of Moldova"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7437-6279","authenticated-orcid":false,"given":"Abdusalam E.","family":"Alrmali","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA"},{"name":"Department of Oral Pathology, Oral Medicine and Oral and Maxillofacial Surgery University of Tripoli, School of Dentistry Tripoli Libya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4238-1799","authenticated-orcid":false,"given":"Hom\u2010Lay","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/jper.19-0032"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2016.160284"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cap.10312"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10024-1179"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v067.i01"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.7525"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.identj.2022.02.005"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1979.50.2.75"},{"issue":"3","key":"e_1_2_11_10_1","first-page":"8","article-title":"Complete Coverage of the Denuded Root Surface With a One\u2010Stage Gingival Graft","volume":"3","author":"Holbrook T.","year":"1983","journal-title":"International journal of periodontics & restorative dentistry"},{"issue":"4","key":"e_1_2_11_11_1","first-page":"327","article-title":"Gingival Grafting in Periodontal Practice: Results of 103 Consecutive Surgeries in 82 Patients","volume":"28","author":"Horning G. 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