The effectiveness of a new method using an extra-alveolar hemostatic agent after dental extractions in older patients on oral anticoagulation treatment: an intrapatient study

Evaluation of early wound healing scales/indexes in oral surgery: A literature review

“…In addition, the scales do not allow for a correlation between the wound healing modifiers tested and the wound healing phases. For example, Pippa et al used Landry's index to evaluate the effect of an extra‐alveolar hemostatic agent (HDD), at application and at hemostasis, in patients receiving oral anticoagulant treatment . However, with this study design, measuring the degree of epithelialization was irrelevant because epithelialization takes place in the proliferative phase, approximately 2‐3 weeks after hemostasis and clot stabilization.…”

“…Pippi et al used another modification of the healing index to evaluate the effectiveness of HemCon Dental Dressing (HDD) in 20 patients who underwent tooth extractions without interruption of oral anticoagulant treatment (INR 1.6‐3.5). The modified index included the following parameters, each rated dichotomically: gingival color (0 = red, 1 = pink); granulation tissue (0 = present, 1 = absent); tissue epithelialization (0 = partial/1 = complete; swelling (0 = presence, 1 = absent) bleeding on palpation (0 = present, 1 = absent); suppuration on palpation (0 = present, 1 = absent).…”

“…The modified index included the following parameters, each rated dichotomically: gingival color (0 = red, 1 = pink); granulation tissue (0 = present, 1 = absent); tissue epithelialization (0 = partial/1 = complete; swelling (0 = presence, 1 = absent) bleeding on palpation (0 = present, 1 = absent); suppuration on palpation (0 = present, 1 = absent). In addition, the test site was compared to the control site and classified as better, equal, or worse . In a split‐mouth design, HDD was applied on the study side and a common hemostatic agent on the other side.…”

“…The authors attributed these findings to the vasoconstrictor properties of adrenaline, which apparently reduced the blood flow to the extraction site. 6 Pippi et al 7 3 = spontaneous). The total score ranged from 4 (excellent healing) to 12 (severely impaired healing).…”

“…In a split-mouth design, HDD was applied on the study side and a common hemostatic agent on the other side. The results showed that HDD treatment was associated with less pain at both the morning after surgery and suture removal (hemostasis), and significantly better socket healing 7. Mozzati et al8 modified the healing index of Landry et al to evaluate the effect of plasma-rich growth factor (PRGF) in improving socket healing without primary closure in 34 patients with insulindependent diabetes undergoing bilateral extraction of homologous teeth.…”