Comparative Efficacy of Two Hemostatic Agents in Post-Extraction Bleeding Control Following Mandibular Third Molar Surgery: A Randomized Clinical Trial.

Abstract

Adequate bleeding control is crucial in surgical procedures. Surgifoam and Hemospon are absorbable hemostatic sponges made from lyophilized porcine gelatin, commonly used in oral surgery. This clinical study aimed to evaluate bleeding control, soft tissue healing, and postoperative pain in dental sockets after mandibular third molar extractions filled with Surgifoam and Hemospon. Twenty-five volunteers requiring extractions of both left and right lower third molars participated in this randomized, double-blind, split-mouth study. After extraction, each socket was randomly filled with Hemospon (test group) or Surgifoam (control group). Postoperative pain was assessed using the Visual Analog Scale (VAS) on days 1, 2, 3, and 7. Bleeding at 30 and 60 min (Souto and Mühlemann scales) and soft tissue healing at 7 and 14 days (Brancaccio scale) were evaluated using Fisher's exact test. Bleeding scores at 30 min predominantly showed no bleeding (score 0) in 80% of participants using Surgifoam, compared to 60% in the Hemospon group. No significant differences in bleeding were observed between groups (p > 0.05), and both showed a similar reduction over time. Soft tissue healing was revealed at 14 days complete healing (score 0) in 90% of participants in both groups. No significant differences between Hemospon^® and Surgifoam^® were observed (p > 0.05). Postoperative pain evaluation showed highly variable scores on the first day (median: 2; range: 1-6) for both Surgifoam^® and Hemospon^®. By the seventh day, pain levels significantly reduced (median: 0), with no significant differences observed between the groups at any time point (p > 0.05). In conclusion, the results of this study suggest that Hemospon and Surgifoam are equally effective in bleeding control, healing, and pain control after third molar surgery. This research aims to guide surgeons on the clinical aspects of using these specific hemostatic sponges in post-extraction procedures for posterior molars and seeks to direct future clinical studies involving these materials.