Blood loss during endodontic surgery

Abstract

The volume of blood lost during endodontic surgery was measured for 60 patients undergoing routine surgical procedures using local anesthesia. Blood loss averaged 9.5 ml for all patients, with a range of 1.2 to 48.4 ml. Operating time was the major variable influencing blood loss; the rate of blood loss correlated very strongly (r = 0.86) with duration of surgery. Other than palatal surgery of maxillary molars, differences in blood loss associated with different teeth were small. Endodontic surgery on any teeth in either arch was far below the level at which fluid replacement therapy might be considered, and was comparable to loss during single tooth extractions.

Bleeding in Endodontic Surgery

“…Selim et al [ 9 ] measured the amount of blood loss during endodontic surgery in different tooth locations and reported that palatal surgery of maxillary molars led to a rate of blood loss almost three times the average for all teeth, and the maxillary fi rst premolar showed blood loss almost double the average for all teeth [ 9 ]. These anatomical effects on the risk of bleeding should be taken under consideration, and a palatal approach is not recommended for endodontic surgery.…”

“…For severe hemorrhage to occur, an insult to a major blood vessel is usually required and is quite rare to happen during minor surgical procedures such as endodontic surgery [ 5 , 8 ]. Blood loss during endodontic surgical procedures on average was found to range from 10 to 50 ml, and the duration of the surgical procedures had an exponential infl uence on the total blood loss [ 9 ]. The immediate danger for a healthy patient with severe postoperative hemorrhage in the oral cavity is airway compromise.…”

Surgical preparation: anesthesia & hemostasis

“…Well‐controlled hemostasis is a critical factor for surgical procedures and the post‐operative course of healing (96, 97). In one study of 60 patients undergoing endodontic surgery, the amount of intra‐operative hemorrhage ranged from 1 to 48 mL, with the duration of surgery being a major predictor of bleeding (98). Although this comparatively small magnitude of bleeding implies that endodontic surgical procedures are generally well tolerated in healthy patients, case reports indicate that patients with coagulopathies may have substantial blood loss during comparatively atraumatic endodontic procedures (99).…”

Effect of Intraosseous Anesthesia on Control of Hemostasis in Pigs

“…Obtaining a dry operation site is essential in the success of endodontic surgery (1). The periapical tissues are highly vascularized with a great tendency toward hemorrhage, especially in the presence of granulomatous tissue accompanying periapical pathology (2). The achievement of adequate hemostasis improves visibility in the surgical site, minimizes surgical time, enhances the surgical procedures (root-end resection, preparation, and filling), and reduces surgical blood loss, postsurgical hemorrhage, and postsurgical swelling (3).…”