A Split-Mouth, Randomized, Double-Blind Clinical Trial of a Gelatin Hemostatic Dental Sponge Containing Aloe Vera Nanoparticles for Controlling Bleeding After Mandibular Posterior Teeth Extraction.

Introduction: Hemostatic dental sponges are biodegradable materials and fast hemostats that can help blood clotting in the surgical site and quick repair of the dental surgery site. In this study, we investigated the bleeding control (blood absorption ability and active bleeding) of a hemostatic gelatin sponge containing aloe vera nanoparticles as a hemostatic material after the removal of mandibular posterior teeth in a doubleblind, randomized trial.

Methods: A clinical trial was performed on 30 patients (13 males and 17 females) who were referred to the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, for extraction of two mandibular molars. The plan was a split-mouth, randomized, double-blind clinical trial. To investigate the blood absorption ability of a hemostatic sponge containing aloe vera nanoparticles in each patient after tooth extraction, the sponge was placed in the socket of the extracted tooth. Sterile gauze was placed on the hemostat sponge containing aloe vera nanoparticles (test group). For the control group, the same process was repeated with a sponge without aloe vera nanoparticles. The number of used sterile gauzes was recorded and the mean excess blood weight was measured with a digital scale. Also, the amount of bleeding after 1 and 4 hours of tooth extraction was recorded for all patients as an active bleeding time.

Results: The number of sterile gauzes used and the mean excess blood weight used in each group indicate blood absorption. The results showed that there was no significant difference in the amount of sterile gauze between the two groups (P=0.65). In both groups, the consumption of three sterile gauzes was the most frequent. However, the mean excess blood weight in the control group was significantly higher, which indicates the better efficiency of the test group (P=0.04). Besides, the examination of the patients showed that in none of the patients of the two groups, active bleeding was observed 1 and 4 hours after tooth extraction.

Conclusion: The performance of the test sponge was better than the control sponge in controlling bleeding after tooth extraction. It seems that the obtained results cannot only be related to the presence of aloe vera nanoparticles. The differences in the bleeding control (blood absorption ability and the active bleeding time) for the used sponges can also influence the results. In addition, the use of aloe vera in the form of nanoparticles can contribute to early healing effects and other beneficial effects, such as antimicrobial effects in the toothextracted site.