Blue-violet light-emitting diode irradiation in combination with hemostatic gelatin sponge (Spongel) application ameliorates immediate socket bleeding in patients taking warfarin

Effectiveness of local hemostatic to prevent bleeding in dental patients on anticoagulation: A systematic review and network meta-analysis

This study aimed to determine the effectiveness of hemostatic protocols to prevent bleeding in dental procedures among individuals undergoing oral anticoagulation therapy. A systematic review and network meta-analysis were accomplished. Searches of literature and grey literature were performed in different electronic databases. Clinical trials were considered as part of the inclusion criteria. Data extraction and assessment of the risk of bias of the included articles were performed. Assessment of the certainty of evidence was also performed. As results we find that the N-butyl-2-cyanoacrylate [RR -35.00 (95% CI - 107.12, -5.78)], calcium sulfate (CaSO₄) [RR -5.62 (95% CI -11.41, -1.03)], and tranexamic acid (TXA) [RR -3.46 (95% CI -7.63, -0.77)] showed beneficial effects compared to placebo. However, only TXA presented beneficial effects with moderate certainty evidence. N-butyl-2-cyanoacrylate and CaSO₄ presented very low certainty evidence. In the comparisons between the hemostatic agents, no differences were observed. For the mean bleeding time, no significant difference in the comparisons was observed as well. Concluding, bleeding events in individuals on oral anticoagulation decreased with the use of TXA compared to placebo. N-butyl-2-cyanoacrylate and CaSO₄ were also superior to placebo, but the certainty of evidence was low. For the mean bleeding time, no significant difference in hemostatic agents was observed.

Haemostasis in Oral Surgery with Blue-Violet Light

BACKGROUND:

The invasive dental procedures usually result in wounds accompanied by physiological bleeding. Even though the bleeding is easily manageable, it is still one of the major concerns of the patients and a reason for their subjective discomfort. Recently, a novel approach with light-emitting diode (LED) was introduced to control the bleeding. This study aims to examine the effectiveness of the irradiation with blue-violet light LEDs on the haemostasis.

MATERIAL AND METHODS:

The study included 40 patients with an indication for tooth extraction, divided into two groups: examination group (n = 30) and a control group (n = 10). The site of the extraction socket in the examination group was irradiated with LED (410 nm) until the bleeding stopped. The patients from the control group were treated by conventional gauze pressure to stop the bleeding (control group). The duration of irradiation and gauze pressure was measured and compared. The statistical analysis was performed with Student T-test.

RESULTS:

The examination group showed the shorter duration of bleeding compared to the control group for 13.67 seconds and 156 seconds, respectively. The most of the cases in the examination group were irradiated in 10 seconds (70%), followed by irradiation of 20 seconds (23.3%) and 30 seconds (6.6%). In the control group, the average time to stop the bleeding by the conventional method was 156 second.

CONCLUSION:

The blue-violet LED light shortens the bleeding time from the extraction socket after tooth extraction and may be a promising method for achieving haemostasis.

LED Phototherapy with Gelatin Sponge Promotes Wound Healing in Mice

Tiny but highly efficient, a light-emitting diode (LED) can power a therapy device, such as a phototherapy device, and, at the same time, decrease the device's size requirements. In this study, a LED phototherapy device was designed to investigate the possible impact on wound healing using a mouse model and a cell line exposed to red and blue light. To enhance wound phototherapy, a gelatin sponge was fabricated. Results showed that the red and blue lights promoted cell growth and wound healing, while the blue light with a gelatin sponge protected the wound from infection in the early stages of wound healing. The LED phototherapy device combined with the gelatin sponge, therefore, has potential significance in clinical application for wound healing.

Improved Thrombin Hemostat Using the Cross-Linked Gelatin by Microbial Transglutaminase

It is well known that the thrombin obtained from animal is available in clinical treatment, which plays an important role in hemostasis and the treatment of hemorrhagic diseases. However, how to achieve complete hemostasis in 2 min is still a challenge. In this report, the thrombin hemostatic has been improved using the cross-linked gelatin by microbial transglutaminase, and its efficacy was demonstrated by the vitro experiment. Compared with the traditional thrombin hemostatic the clotting time with the improved hemostat is significantly shorter. It may rapidly stop blood loss, which would provide a simple, safe, and cost-effective surgical sealant.