Horizontal Mattress Sutures Palate — MFDS Part 1 MCQ

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ModerateOral Surgery PrinciplesHorizontal Mattress Sutures PalateMFDS Part 1

During closure of a full-thickness palatal mucoperiosteal flap, the edges can be approximated, but simple interrupted sutures concentrate force at individual bite points and begin to cut into the thick, relatively immobile mucosa. Which suture technique would best distribute the load across a broader area of the flap margin?

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Correct answer: B — Horizontal mattress sutures

Horizontal mattress sutures are appropriate because each suture spans a broader segment of tissue, helping distribute the closing force and reduce focal pull-through when a thick, relatively immobile palatal flap is under tension. They must not be overtightened, as excessive compression can compromise perfusion. Simple interrupted sutures reproduce the focal loading described in the stem. Subcuticular suturing is primarily suited to selected low-tension cutaneous wounds rather than full-thickness oral mucoperiosteal flap closure. A purse-string suture is used mainly to constrict a circular defect, while a continuous locking suture can provide rapid closure but is not the best listed technique for targeted tension redistribution across this flap margin.

Reference: Kim G-J, Joo Y-S, Lee D-W, Lee J-S. Initial wound healing following interrupted closing sutures with versus without tension-relieving mattress suture in guided bone regeneration: a preliminary randomized clinical trial. Journal of Periodontal & Implant Science. 2026. https://pubmed.ncbi.nlm.nih.gov/41968716/