Clinical and histological investigation of calcium sulfate and HemCon dental dressing as ahemostatic agent

Abstract

Background: Hemostasis control is essential for the success of endodontic surgical procedures. There are many agents used for hemostasis but no material has yet been found that fulfills all or most properties for an ideal hemostatic agent. Aim: The aim of the present study was to compare hemostatic efficacy of calcium sulfate (CaS) and HemCon Dental Dressing (HemCon) during periapical surgery and wound healing potential of these agents in osseous surgical wound sites of rats. Methods: Thirty teeth in 29 healthy patients were included in clinical phase. Hemostasis was attempted by using CaS, HemCon and epinephrine-impregnated cotton pellets (RECP group). The hemostatic efficacy was determined by using the following scores: 0 (no hemorrhage control), 1 (slight but apparent intermittent bleeding), and 2 (complete hemorrhage control). In the laboratory phase, 32 male Sprague Dawley rats’ tibias were used. Three main groups were formed in the study (CaS, HemCon and control). According to the days of sacrifice, all groups were divided into two subgroups: 14th day and 28th day. In order to evaluate the effects of CaS and HemCon materials on bone tissue; new bone formation and foreign body reaction were investigated. The experimental materials in CaS and HemCon groups were leaved in the right tibias during the experiment but lefts were completely curetted. Results: In CaS and RECP clinical groups, 5 cases were categorized with a score of 2 (HemCon group: 6 case). In all groups, one case was categorized with a score of 0. According to histologic results, there was a statistically significant difference between the new bone formation on the 28th day(p<0.05). The highest new bone formation was detected in CaS 28th day group. Discussion and Conclusion: CaS and HemCon are effective hemostatic agents and fairly tissue-friendly materials. Further investigation on these materials, they can replace epinephrine-impregnated cotton pellets.