A vertical mattress suture is a horizontal mattress turned 90 degrees. Useful to close tissues with good deep layer closure, the vertical mattress is often utilized to reapproximate papilla, form thicker tissue around implant healing abutments, or help to close tall vertical tissue margins. The needle pass pattern is deep-deep-shallow-shallow. The first pass is on the buccal tissue and bites deep to the margin, passing through the wound and exiting on the lingual tissue equally as deep to the margin. The third bite is on the lingual tissue more coronal to the second bite, back out the buccal tissue also more coronal to the first bite.
