Haemostatic effect and tissue reactions of methods and agents used for haemorrhage control in apical surgery

Jensen, Simon Storgård; Yazdi, Pouya Masroori; Hjörting-Hansen, E.; Bosshardt, Dieter D.; Arx, Thomas von

doi:10.1111/j.1365-2591.2009.01637.x

Cited by 29 publications

(32 citation statements)

References 14 publications

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“…Previous experimental work on this area of research has been performed both in inferior animals, like Wistar rat (21), Sprague-Dawley rat (16,22,23), New Zealand rabbit (10,(24)(25)(26) or Burgundy rabbit (13,14), or in higher order species, like Beagle dogs (17,27,28), or swines (15,29). Previous experimental work on this area of research has been performed both in inferior animals, like Wistar rat (21), Sprague-Dawley rat (16,22,23), New Zealand rabbit (10,(24)(25)(26) or Burgundy rabbit (13,14), or in higher order species, like Beagle dogs (17,27,28), or swines (15,29).…”

Section: Discussionmentioning

confidence: 99%

“…Delay in collagen deposition can lead to an increase in the risk of inflammatory reactions at the surgical bed and worsen the final restitution ad integrum. This aggressive management can lead to abnormalities of the sealing material and their properties (14). Kopac et al (30) showed an intense inflammatory reaction in the soft tissue of the animals treated with aluminum chloride.…”

Section: Discussionmentioning

confidence: 99%

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Histological analysis of different local haemostatic agents used for periapical surgery: An experimental study with Sprague‐Dawley rats

et al. 2019

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Histological analysis of different local haemostatic agents used for periapical surgery: An experimental study with Sprague‐Dawley rats

et al. 2019

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“…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. In a similar study, Jensen et al (14) found that the foreign body reactions produced in the presence of Expasyl™ and ferric sulfate did not occur if the bone cavity was refreshed with rotary instruments and irrigation.…”

Section: Introductionmentioning

confidence: 89%

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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“…The authors therefore recommended cleaning the surgical wound with a curette and refreshing the bone walls with a rounded drill before wound closure. Jensen et al (10) noted that adverse reactions to Expasyl™ did not occur if the traces of the paste were eliminated from the bone crypt with rotary instruments. In our study we favored bleeding within the bone cavity before suturing, and the teeth in the Expasyl™ group had a better prognosis than those belonging to the anesthetic solution with vasoconstrictor group after 12 months of follow-up and on occasion of the last control visit (non significant differences) – though not so at the first control after 6 months.…”

Section: Discussionmentioning

confidence: 99%

“…Expasyl™ alone or in combination with ferric sulfate was found to be the most effective agent, and the inflammatory reactions were limited to the bone defects, with no spread to the surrounding tissues. Jensen et al (10) used the same study design to compare the effects of 5 hemostatic techniques: Expasyl™ + Stasis®, Expasyl™ + Stasis® + bone crypt freshening with a drill, Spongostan®, Spongostan® + adrenaline, and electrocautery. The most effective methods for reducing bleeding were Expasyl™ + Stasis® and electrocautery, but adverse tissue reactions were observed (necrotic bone, inflammatory cells, absence of bone repair).…”

Section: Introductionmentioning

confidence: 99%

Influence of hemostatic agents upon the outcome of periapical surgery: Dressings with anesthetic and vasoconstrictor or aluminum chloride

Peñarrocha-Diago

Maestre-Ferrín²,

Peñarrocha‐Oltra³

et al. 2013

Med Oral

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Objective: To evaluate the effects of different hemostatic agents upon the outcome of periapical surgery. Design: A retrospective study was made of patients subjected to periapical surgery between 2006-2009 with the ultrasound technique and using MTA as retrograde filler material. We included patients with a minimum follow-up of 12 months, divided into two groups according to the hemostatic agent used: A) dressings impregnated in anesthetic solution with adrenalin; or B) aluminum chloride paste (Expasyl™). Radiological controls were made after 6 and 12 months, and on the last visit. The global evolution scale proposed by von Arx and Kurt (1999) was used to establish the outcome of periapical surgery. Results: A total of 96 patients (42 males and 54 females) with a mean age of 40.7 years were included. There were 50 patients in the aluminum chloride group and 46 patients in the anesthetic solution with vasoconstrictor group. No significant differences were observed between the two groups in terms of outcome after 12 months - the success rate being 58.6% and 61.7% in the anesthetic solution with vasoconstrictor and aluminum chloride groups, respectively (p>0.05). Conclusion: The outcome after 12 months of follow-up was better in the aluminum chloride group than in the anesthetic solution with vasoconstrictor group, though the difference was not significant. Key words:Aluminum chloride, bleeding control, hemostasis, periapical surgery, outcome.

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Haemostatic effect and tissue reactions of methods and agents used for haemorrhage control in apical surgery

Abstract: Haemostasis in experimental bone defects is most effectively accomplished by using Expasyl + Stasis or electro cauterization. However, the bone defects should be freshened with a rotary instrument before suturing so as not to compromise healing.

Cited by 29 publications

References 14 publications

Histological analysis of different local haemostatic agents used for periapical surgery: An experimental study with Sprague‐Dawley rats

Histological analysis of different local haemostatic agents used for periapical surgery: An experimental study with Sprague‐Dawley rats

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

Influence of hemostatic agents upon the outcome of periapical surgery: Dressings with anesthetic and vasoconstrictor or aluminum chloride

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