Relevance of Silk Sutures in Contemporary Dental Practice: A Narrative Review

Silk sutures have long served as a standard non-absorbable material in dental surgical practice and are valued for their handling characteristics, cost-effectiveness, and predictable clinical performance.This narrative review synthesizes the current evidence on the applications, advantages, limitations, and emerging trends associated with silk sutures in contemporary dentistry.Silk continues to be widely applied in third molar extraction, periodontal flap surgery, and dentoalveolar wound closure, often serving as the comparator material against which newer techniques and products are benchmarked.Its principal advantages include favorable pliability, ease of knot placement and removal, low material cost, and clinically acceptable outcomes when properly executed, making it especially suitable for trainee education and high-volume practice settings.However, the braided multifilament structure of silk is consistently associated with greater bacterial colonization than monofilament and coated alternatives, along with reduced tensile strength after exposure to certain beverages.These limitations have driven growing interest in knotless barbed sutures, cyanoacrylate tissue adhesives, antimicrobial nanoparticle coatings, and silk fibroin-based biomaterials as complementary or alternative closure strategies.Overall, silk remains a clinically relevant and accessible suture material for routine dental procedures, whereas emerging technologies offer targeted solutions for cases in which infection risk, prolonged suture retention, or patient sensitivity warrants an alternative selection.