Haemostatic agents used in periradicular surgery: an experimental study of their efficacy and tissue reactions

Arx, Thomas von; Jensen, Simon Storgård; Hänni, Stefan; Schenk, Robert K.

doi:10.1111/j.1365-2591.2006.01152.x

Cited by 37 publications

(32 citation statements)

References 14 publications

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“…Von Arx et al (11) introduced the use of Expasyl™, a paste containing aluminum chloride and kaolin and commonly used to produce gingival retraction (12,13). In an experimental study, these same authors (11) compared the hemostatic efficacy and tissue reactions of bone wax, ferric sulfate, Expasyl™ and a combination of Expasyl™ and ferric sulfate. Expasyl™ alone or in combination with ferric sulfate appeared to be the most efficient agent, and the inflammatory tissue reactions were limited to the bone defects, never extending into the surrounding tissues.…”

Section: Introductionmentioning

confidence: 99%

Pain and swelling after periapical surgery related to the hemostatic agent used: Anesthetic solution with vasoconstrictor or aluminum chloride

Peñarrocha-Diago

Maestre-Ferrín²,

Peñarrocha‐Oltra³

et al. 2012

Med Oral

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Objective: To assess pain and swelling in the first 7 days after periapical surgery and their relationship with the agent used for bleeding control. Study Design: A prospective study was conducted between October 2006 and March 2009. Patients subjected to root surgery, who completed the questionnaire and who consented to the postoperative instructions were included in the study. The subjects were divided into two groups according to the hemostatic agent used: A) gauze impregnated with anesthetic solution with vasoconstrictor; or B) aluminum chloride. The patients were administered a questionnaire, and were asked to record the severity of their pain and swelling on a plain horizontal visual analog scale (VAS). Data were recorded by the patients on the first 7 postoperative days. In addition, the patients were asked to record analgesic consumption. Results: A total of 76 questionnaires (34 in group A and 42 in group B) were taken to be correctly completed. Pain was reported to be most intense two hours after surgery. At this point 52.6% of the patients had no pain. Seventy-five percent of the patients consumed analgesics in the first 24 hours. There were no significant differences between the two groups in terms of the intensity of pain or in the consumption of analgesics. Swelling reached its maximum peak on the second day; at this point, 60.6% of the patients suffered mild or moderate swelling. The Expasyl™ group showed significantly greater swelling than the gauzes group. Conclusion: The type of hemostatic agent used did not influence either the degree of pain or the need for analgesia among the patients in this study. However, the patients belonging to the Expasyl™ group suffered greater swelling than the patients treated with gauzes impregnated with anesthetic solution with vasoconstrictor. Key words:Hemostasis, periradicular surgery, aluminum chloride, pain, swelling.

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Section: Introductionmentioning

confidence: 99%

Pain and swelling after periapical surgery related to the hemostatic agent used: Anesthetic solution with vasoconstrictor or aluminum chloride

Peñarrocha-Diago

Maestre-Ferrín²,

Peñarrocha‐Oltra³

et al. 2012

Med Oral

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“…The authors attribute this swelling to the fact that the study was not randomised and not to any inflammatory reaction of Expasyl®. Indeed, an animal study of von Arx et al in 2006 stated that this inflammatory reactions are limited to bone defects and no adverse tissue reactions are seen in the vicinity of bone defects (23). Future randomised studies in humans are needed to analyse this possible association.…”

Section: Discussionmentioning

confidence: 99%

Haemostatic agents in apical surgery. A systematic review

Clé-Ovejero¹,

Valmaseda‐Castellón²

2016

Med Oral

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BackgroundBlood presence in apical surgery can prevent the correct vision of the surgical field, change the physical properties of filling materials and reduce their sealing ability. ObjetiveTo describe which are the most effective and safest haemostatic agents to control bleeding in patients undergoing apical surgery.Material and MethodsTWe carried out a systematic review, using Medline and Cochrane Library databases, of human clinical studies published in the last 10 years.ResultsThe agents that proved more effective in bleeding control were calcium sulphate (100%) and collagen plus epinephrine (92.9%) followed by ferric sulphate (60%), gauze packing (30%) and collagen (16.7%). When using aluminium chloride (Expasyl®), over 90% of the apical lesions improved, but this agent seemed to increase swelling. Epinephrine with collagen did not significantly raise either blood pressure or heart rate.ConclusionsDespite the use of several haemostatic materials in apical surgery, there is little evidence on their effectiveness and safety. The most effective haemostatic agents were calcium sulphate and epinephrine plus collagen. Epinephrine plus collagen did not seem to significantly raise blood pressure or heart rate during surgery. Aluminium chloride did not increase postoperative pain but could slightly increase postoperative swelling. Randomized clinical trials are needed to assess the haemostatic effectiveness and adverse effects of haemostatic materials in apical surgery. Key words:Haemostasis, apical surgery.

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“…Diese Problematik kann partiell durch «abdichtende» Maßnahmen umgangen werden [30]. Die Resultate von Interventionsstudien mit Antifibrinolytika erlauben wiederum abzuleiten, dass auch in diesem Patientengut die Regulierung der Fibrinolyse eine relevante Rolle spielt [31].…”

Section: Unterschiedliche Pathophysiologische Hintergründe Von Koagulunclassified

Peri- und intraoperative Gerinnungsstörungen und ihre Therapieempfehlungen

Korte¹

2013

Visc Med

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Hintergrund: Aufgrund neuer diagnostischer Technologien und der zunehmenden Verfügbarkeit von Gerinnungsfaktorkonzentraten hat die perioperative Hämostase in den letzten Jahren zunehmende Aufmerksamkeit erhalten. Methode: Die Literatur wurde im Hinblick auf die Diagnostik, Pathophysiologie und Behandlungsmöglichkeiten von peri- und intraoperativen Gerinnungsstörungen sowie bezüglich eigener Erfahrungen in den verschiedenen erwähnten Bereichen durchsucht. Ergebnisse und Schlussfolgerungen: Peri- und intraoperative Hämostasestörungen sind nicht selten. Sie sind in der Regel mit einem strukturierten diagnostischen Vorgehen klinisch einfach zu erfassen. Mittlerweile können innerhalb der unterschiedlichen klinischen Entitäten verschiedene zugrunde liegende Pathophysiologien identifiziert werden; damit können auch die entsprechenden, zum Teil unterschiedlichen Behandlungsmethoden zum Einsatz gebracht werden. Die kontinuierliche Beobachtung der klinischen Situation zusammen mit unter Umständen wiederholten Laboruntersuchungen erlaubt die frühzeitige Erfassung und Behandlung.

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Haemostatic agents used in periradicular surgery: an experimental study of their efficacy and tissue reactions

Abstract: Expasyl alone or in combination with Stasis appeared to be the most efficient of tested agents to control the bleeding within the bony defects created in a rabbit calvarium model.

Cited by 37 publications

References 14 publications

Pain and swelling after periapical surgery related to the hemostatic agent used: Anesthetic solution with vasoconstrictor or aluminum chloride

Pain and swelling after periapical surgery related to the hemostatic agent used: Anesthetic solution with vasoconstrictor or aluminum chloride

Haemostatic agents in apical surgery. A systematic review

Peri- und intraoperative Gerinnungsstörungen und ihre Therapieempfehlungen

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