TY - JOUR
T1 - Haemostatic agents used in periradicular surgery
T2 - an experimental study of their efficacy and tissue reactions
AU - von Arx, T
AU - Jensen, S S
AU - Hänni, S
AU - Schenk, R K
PY - 2006/10
Y1 - 2006/10
N2 - AIM: To evaluate the haemostatic efficacy and the histologic tissue responses after the application of different haemostatic agents used in periradicular surgery.METHODOLOGY: The study was conducted in the calvarium of six rabbits. Standardized bone defects (diameter 4 mm) were trephined, and different haemostatic agents were applied and compared with control defects: bone wax (left for 10 min), Stasis (ferric sulphate, left for 5 s), Expasyl (aluminium chloride, left for 2 min and left permanently in situ), and a combination of Expasyl (2 min) and Stasis (5 s). The sites were photographed before the application and after the removal of the haemostatic agents. Three independent examiners judged the initial and final bleeding (on the photographs) using a bleeding score for each site and treatment. The results were compared using Wilcoxon's signed rank test. For the histologic analysis, three animals were killed after 3 weeks and three animals after 12 weeks. Transverse, nondecalcified sections were stained with combined basic fuchsin and toluidine blue for descriptive histology.RESULTS: The most efficient haemorrhage control was provided by Expasyl in combination with Stasis and by Expasyl alone, whereas bone wax had the weakest bleeding reduction effect. The histologic analysis after 3 weeks demonstrated an inflammatory and foreign body tissue response towards all haemostatic agents. At 12 weeks, this tissue response was less pronounced but still present in sites treated with bone wax or Expasyl. In general, the inflammatory tissue reactions were limited to the bone defects, and never extended into the surrounding tissues.CONCLUSIONS: 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.
AB - AIM: To evaluate the haemostatic efficacy and the histologic tissue responses after the application of different haemostatic agents used in periradicular surgery.METHODOLOGY: The study was conducted in the calvarium of six rabbits. Standardized bone defects (diameter 4 mm) were trephined, and different haemostatic agents were applied and compared with control defects: bone wax (left for 10 min), Stasis (ferric sulphate, left for 5 s), Expasyl (aluminium chloride, left for 2 min and left permanently in situ), and a combination of Expasyl (2 min) and Stasis (5 s). The sites were photographed before the application and after the removal of the haemostatic agents. Three independent examiners judged the initial and final bleeding (on the photographs) using a bleeding score for each site and treatment. The results were compared using Wilcoxon's signed rank test. For the histologic analysis, three animals were killed after 3 weeks and three animals after 12 weeks. Transverse, nondecalcified sections were stained with combined basic fuchsin and toluidine blue for descriptive histology.RESULTS: The most efficient haemorrhage control was provided by Expasyl in combination with Stasis and by Expasyl alone, whereas bone wax had the weakest bleeding reduction effect. The histologic analysis after 3 weeks demonstrated an inflammatory and foreign body tissue response towards all haemostatic agents. At 12 weeks, this tissue response was less pronounced but still present in sites treated with bone wax or Expasyl. In general, the inflammatory tissue reactions were limited to the bone defects, and never extended into the surrounding tissues.CONCLUSIONS: 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.
KW - Aluminum Chloride
KW - Aluminum Compounds/adverse effects
KW - Animals
KW - Chlorides/adverse effects
KW - Drug Combinations
KW - Ferric Compounds/adverse effects
KW - Foreign-Body Reaction/etiology
KW - Hemostatics/adverse effects
KW - Palmitates/adverse effects
KW - Periapical Tissue/surgery
KW - Rabbits
KW - Skull/surgery
KW - Statistics, Nonparametric
KW - Waxes/adverse effects
U2 - 10.1111/j.1365-2591.2006.01152.x
DO - 10.1111/j.1365-2591.2006.01152.x
M3 - Journal article
C2 - 16948666
SN - 0143-2885
VL - 39
SP - 800
EP - 808
JO - International Endodontic Journal Online
JF - International Endodontic Journal Online
IS - 10
ER -