Comparative analysis of the efficacy of local hemostatic agents in minor oral surgical procedures A clinical study

In oral surgery, both intraoperative and postoperative bleeding can pose significant risks to patients, potentially leading to severe complications if not properly controlled. It is essential for clinicians to be well-acquainted with the different hemostatic agents available and their appropriate use in various bleeding situations. Bleeding complications can occur in both healthy and medically compromised individuals. During oral surgical procedures, bleeding not only causes patient distress, pain, and discomfort but also interrupts the surgeon’s focus, resulting in frustration and prolonged procedure times. Tooth extraction is a common and invasive oral surgery performed in everyday dental practice, with post extraction bleeding being a frequent and acknowledged complication. Post extraction bleeding is defined as the presence of bleeding beyond the pressure pack. A variety of methods have been proposed to manage post extraction bleeding, applicable to both healthy and medically compromised patients. Management strategies can generally be divided into local and systemic approaches. Local interventions include the use of saline pressure packs, sutures, acrylic surgical splints, and local hemostatic agents. Local hemostatic agents used in oral surgery are divided into passive and active types. These include oxidized cellulose, resorbable gelatin sponges, collagen sponges, polysaccharide hemospheres, thrombin, cyanoacrylate glue, fibrin glue, antifibrinolytic mouthwashes like tranexamic acid, bone wax, ostene, calcium alginate, chitosan-based dressings, polysaccharide hemostats, tannic acid, and hemocoagulase. When necessary, systemic hemostatic agents can also be employed to help control bleeding. Unfortunately, many effective preventive and management strategies are underutilized due to insufficient knowledge about the coagulation process and the available materials and techniques. This study aims to assess the effectiveness of various chemical local hemostatic agents in controlling bleeding during oral surgical procedures.