The aim of the current investigation was to review techniques and materials available to achieve bleeding control during periapical surgery. An adequate bleeding control is crucial, since it improves vision in the surgical site, minimizes surgical time, enhances the root-end resection and filling, and reduces surgical blood loss, postsurgical hemorrhage and postsurgical swelling.
Methods: An update is made of the aspects to be considered during bleeding control in periapical surgery.
Results: The hemostatic agents that have been proposed in the literature have characteristics that make them very different from each other, such as the mechanism of action, commercial presentation, hemostatic efficacy and systemic effects.
Conclusion: The hemostatic agents that have obtained the best results are ferric sulfate, calcium sulfate, aluminum chloride and epinephrine. Nevertheless, there is no consensus in the literature on which is the ideal hemostatic agent.
Editorial note: The full article was published in the 3/2018 issue of the Journal of Oral Science and Rehabilitation. It can be accessed free of charge at www.dtscience.com.
Interview with Isabel Menéndez Nieto
Ms. Menéndez Nieto, why did you conduct the research reported on in this paper?
It is intended to provide an update of all the clinical and biological aspects to be considered during bleeding control in periapical surgery.
For what reasons could others cite your paper?
The ability to achieve tissue hemostasis in the surgical site is crucial to the performance of periapical surgery; nevertheless, the number of publications on this field is very scarce.
How could your study’s findings have an impact on dentistry?
This article updates professionals from a scientific and clinical perspective, since some of the most relevant aspects of hemostatic agents are detailed: mechanism of action, commercial presentation, techniques for application, hemostatic efficacy and adverse effects.
What is the relevance of your study’s findings to the daily practice of a dentist?
This paper is written as a guideline for clinicians. The characteristics and the results reported in the literature of the various hemostatic agents proposed for the control of hemorrhage in periapical surgery are detailed.
What are your recommendations for further investigation of the topic of your article?
Further studies with a randomized controlled design are needed to improve knowledge about bleeding control. Studies should be designed to analyze the influence of hemostatic materials used on the long-term prognosis.
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