Skip to content
2000
image of 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

Abstract

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 double-blind, 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 (=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 (=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 tooth-extracted site.

Loading

Article metrics loading...

/content/journals/cpd/10.2174/0113816128363906250407111215
2025-05-16
2025-09-04
Loading full text...

Full text loading...

References

  1. Nakamura J. Nakatsuka K. Uchida K. Akisue T. Maeda M. Murata F. Fukuda H. Ono R. Analysis of post‐extraction bleeding in patients taking antithrombotic therapy using data from the longevity improvement and fair evidence study. Gerodontology 2024 41 2 269 275 10.1111/ger.12703 37469221
    [Google Scholar]
  2. Piry P. Esmaeeli A. Mahdipour A. Asayesh H. The effect of using Gelatamp on pain and gingival bleeding after tooth extraction: A randomize clinical trial. Majallah-i Danishgah-i Ulum-i Pizishki-i Qum 2018 12 8 10 18 10.29252/qums.12.8.10
    [Google Scholar]
  3. Signor B. Poli Kopper P.M. Aspesi M. Münchow E.A. Scarparo R.K. Postoperative pain after single-visit root canal treatment or vital pulp therapy. J. Am. Dent. Assoc. 2024 155 2 118 137.e1 10.1016/j.adaj.2023.11.008 38325970
    [Google Scholar]
  4. Mahmoudi A. Ghavimi M.A. Maleki Dizaj S. Sharifi S. Sajjadi S.S. Jamei Khosroshahi A.R. Efficacy of a new hemostatic dental sponge in controlling bleeding, pain, and dry socket following mandibular posterior teeth extraction: A split-mouth randomized double-blind clinical trial. J. Clin. Med. 2023 12 14 4578 10.3390/jcm12144578 37510692
    [Google Scholar]
  5. Duan Y. Zhang E. Fang R.H. Gao W. Zhang L. Capsulated cellular nanosponges for the treatment of experimental inflammatory bowel disease. ACS Nano 2023 17 16 15893 15904 10.1021/acsnano.3c03959 37565604
    [Google Scholar]
  6. Maleki-Dizaj S. Karimpour A. Aloe vera-containing sponge gelatin gelfoam: In vitro antimicrobial action and hemostatic effect. J. Adv Chem Pharm Mater 2020 3 225 228
    [Google Scholar]
  7. Shirafkan S. Razavi M. Bavarsad Shahri Pour A. The effect of gelfoam soaked in dexamethasone on swelling, bleeding, and pain after third molars of mandible surgery. Majallah-i Ilmi-i Pizishki-i Jundi/Shapur 2018 17 439 448
    [Google Scholar]
  8. Ferretti L. Qiu X. Villalta J. Lin G. Efficacy of BloodSTOP iX, surgicel, and gelfoam in rat models of active bleeding from partial nephrectomy and aortic needle injury. Urology 2012 80 5 1161.e1 1161.e6 10.1016/j.urology.2012.06.048 22921708
    [Google Scholar]
  9. Eikelboom J.W. Hirsh J. Bleeding and management of bleeding. Eur. Heart J. Suppl. 2006 8 Suppl. G G38 G45 10.1093/eurheartj/sul054
    [Google Scholar]
  10. Gorgieva S. Kokol V. Collagen-vs. gelatine-based biomaterials and their biocompatibility: Review and perspectives.Biomaterials applications for nanomedicine. Biomaterials Applications for Nanomedicine. Pignatello R. USA InTech 2011
    [Google Scholar]
  11. Irfan N.I. Mohd Zubir A.Z. Suwandi A. Haris M.S. Jaswir I. Lestari W. Gelatin-based hemostatic agents for medical and dental application at a glance: A narrative literature review. Saudi Dent. J. 2022 34 8 699 707 10.1016/j.sdentj.2022.11.007 36570577
    [Google Scholar]
  12. Li L. Du Y. Yin Z. Li L. Peng H. Zheng H. Yang A. Li H. Lv G. Preparation and the hemostatic property study of porous gelatin microspheres both in vitro and in vivo. Colloids Surf. B Biointerfaces 2020 187 110641 10.1016/j.colsurfb.2019.110641 31759778
    [Google Scholar]
  13. Dapper D.V. Achinike P.N. Gwotmut M.D. The effects of Aloe vera [gel] on clotting time, prothrombin time and plasma fibrinogen concentration in albino Wistar rats. Port. Harcourt. Med. J. 2007 2 1 56 60 10.4314/phmedj.v2i1.38894
    [Google Scholar]
  14. Kishore K. Effect of aloe vera (Aloe barbadensis) on thrombosis in mice. Pharmacologia 2015 6 8 347 354 10.5567/pharmacologia.2015.347.354
    [Google Scholar]
  15. Bhardwaj A. Bhardwaj A. Misuriya A. Maroli S. Manjula S. Singh A.K. Nanotechnology in dentistry: Present and future. J. Int. Oral Health 2014 6 1 121 126 24653616
    [Google Scholar]
  16. Balaji A. Vellayappan M.V. John A.A. Subramanian A.P. Jaganathan S.K. SelvaKumar M. Mohd Faudzi A.A. Supriyanto E. Yusof M. Biomaterials based nano-applications of Aloe vera and its perspective: A review. RSC Advances 2015 5 105 86199 86213 10.1039/C5RA13282G
    [Google Scholar]
  17. Zaheri Khosroshahi A. Ghavimi M.A. Sharifi S. Baghban Vazirabadi S. Deljavanghodrati T. Maleki Dizaj S. A biodegradable and biocompatible dental hemostatic gelatin sponge containing aloe vera nanoparticles: Investigation in rat animal model. Pharm. Nanotechnol. 2025 1 1 12
    [Google Scholar]
  18. Yang G. Xiao Z. Long H. Ma K. Zhang J. Ren X. Zhang J. Assessment of the characteristics and biocompatibility of gelatin sponge scaffolds prepared by various crosslinking methods. Sci. Rep. 2018 8 1 1616 10.1038/s41598‑018‑20006‑y 29371676
    [Google Scholar]
  19. Hackley B. Immune Response. Primary Care of Women: A Guide for Midwives and Women's Health Providers. 2006 USA Jones, Bartlett Learning
    [Google Scholar]
  20. Lan G. Lu B. Wang T. Wang L. Chen J. Yu K. Liu J. Dai F. Wu D. Chitosan/gelatin composite sponge is an absorbable surgical hemostatic agent. Colloids Surf. B Biointerfaces 2015 136 1026 1034 10.1016/j.colsurfb.2015.10.039 26590895
    [Google Scholar]
  21. Xie X. Li D. Chen Y. Shen Y. Yu F. Wang W. Yuan Z. Morsi Y. Wu J. Mo X. Conjugate electrospun 3D gelatin nanofiber sponge for rapid hemostasis. Adv. Healthc. Mater. 2021 10 20 2100918 10.1002/adhm.202100918 34235873
    [Google Scholar]
  22. Hajosch R. Suckfuell M. Oesser S. Ahlers M. Flechsenhar K. Schlosshauer B. A novel gelatin sponge for accelerated hemostasis. J. Biomed. Mater. Res. B Appl. Biomater. 2010 94B 2 372 379 10.1002/jbm.b.31663 20578223
    [Google Scholar]
  23. Maan A.A. Nazir A. Khan M.K.I. Ahmad T. Zia R. Murid M. Abrar M. The therapeutic properties and applications of Aloe vera : A review. J. Herb. Med. 2018 12 1 10 10.1016/j.hermed.2018.01.002
    [Google Scholar]
  24. Prakoso Y.A. Kurniasih The effects of Aloe vera cream on the expression of CD4+ and CD8+ lymphocytes in skin wound healing. J. Trop. Med. 2018 2018 1 5 10.1155/2018/6218303 29666657
    [Google Scholar]
  25. Nalimu F. Oloro J. Peter E.L. Ogwang P.E. Acute and sub-acute oral toxicity of aqueous whole leaf and green rind extracts of Aloe vera in Wistar rats. BMC Complem. Med. Therap. 2022 22 1 16 10.1186/s12906‑021‑03470‑4 35031035
    [Google Scholar]
  26. Jafari S.M. McClements D.J. Nanotechnology approaches for increasing nutrient bioavailability. Adv. Food Nutr. Res. 2017 81 1 30 10.1016/bs.afnr.2016.12.008 28317602
    [Google Scholar]
  27. Fu P.P. Xia Q. Hwang H-M. Ray P.C. Yu H. Mechanisms of nanotoxicity: Generation of reactive oxygen species. J. Food Drug Analy 2014 22 1 64 75 24673904
    [Google Scholar]
  28. Shringirishi M. Prajapati S.K. Mahor A. Alok S. Yadav P. Verma A. Nanosponges: A potential nanocarrier for novel drug delivery-a review. Asian Pac. J. Trop. Dis. 2014 4 S519 S526 10.1016/S2222‑1808(14)60667‑8
    [Google Scholar]
  29. Silva S.S. Oliveira M.B. Mano J.F. Reis R.L. Bio-inspired Aloe vera sponges for biomedical applications. Carbohydr. Polym. 2014 112 264 270 10.1016/j.carbpol.2014.05.042 25129743
    [Google Scholar]
  30. Wang Y.Z. Guan Q.L. Li Y.X. Guo J.L. Jiang L. Jia M.Y. Deng Y. Use of “gelatamp” colloidal silver gelatin sponge to prevent dry socket after extracting mandibular impacted teeth. West. China. J. Stomatol 2013 22 1 108 110 23552793
    [Google Scholar]
  31. Thuruthel M.J. Surej Kumar L.K. Kurien N.M. Tharakan M. Efficacy of gelatamp in controlling the postoperative sequelae following mandibular posterior teeth extraction: A split-mouth study. J. Oral Biol. Craniofac. Res. 2023 13 2 96 103 10.1016/j.jobcr.2022.11.006 36561420
    [Google Scholar]
  32. Poor M.R. Hall J.E. Poor A.S. Reduction in the incidence of alveolar osteitis in patients treated with the SaliCept Patch, containing Acemannan Hydrogel. J. Oral Maxillofac. Surg. 2002 60 4 374 379 10.1053/joms.2002.31222 11928091
    [Google Scholar]
/content/journals/cpd/10.2174/0113816128363906250407111215
Loading
/content/journals/cpd/10.2174/0113816128363906250407111215
Loading

Data & Media loading...


  • Article Type:
    Research Article
Keywords: sponge ; Hemostat ; aloe vera ; gelatin ; nanoparticles ; tooth extraction
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test