Cardiovascular Effects and Efficacy of a Hemostatic Agent in Periradicular Surgery

By Vy CH, Baumgartner JC , Marshall JG

Date: 11/2014
Journal: JOE

Summary:  

Purpose: evaluate the hemostatic efficacy of CollaCote saturated with 2.25% racemic epinephrine during periradicular surgery and determine whether there was any significant change in blood pressure or pulse rate.

Materials/Methods:

  •48 patients participated in this study

•The patients were assigned to one of two groups. In group 1 (control), patients received CollaCote saturated with saline. In group 2 (experimental), patients received CollaCote saturated with 10 drops of 2.25% racepinephrine inhalation solution for bronchodilator

•Preoperative blood pressure and pulse rate was recorded. Once profound local anesthesia was achieved, blood pressure and pulse rate were recorded again

•final blood pressure and pulse rate was obtained before the patient’s dismissal.

A Most highlighted Results: 

  1.No significant difference in blood pressure or pulse rate at any time period between the experimental  and control groups

2.In group 1 : hemorrhage control was not achieved in five of six cases. Racellets #3 were used to obtain hemostasis

3.In group 2 : complete hemorrhage control was achieved in 39 of 42 cases ( 2 patient had slight intermittent bleeding and  one patient had no hemorrhage control

Clinical significance: 

We should consider use CollaCote with  2.25 % epinephrine  in our practice in endodontic surgery because the majority of the cases in this study showed excellent hemostasis with no changes in blood pressure or pulse rate . 

Intentional replantation definition :

Accepted endodontic treatment procedure in which a tooth is extracted and treated outside the oral cavity and then inserted into its socket to correct an obvious radiographic or clinical endodontic failure

Indications :
-failure of root canal treatment
-Anatomical consideration
-Accessibility problems
-Trismus
-patient objection to conventional surgical root canal treatment
-When the patient can’t afford the cost of surgical root canal treatment


Contraindication :
-Curved roots
– Periodontal involvement
– Broken  tooth ( vertical fracture or non restorable )