Jang Youngjune, Kim Hyeon, Roh Byoung-Duck, Kim Euiseong
Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea.
Restor Dent Endod. 2014 May;39(2):79-88. doi: 10.5395/rde.2014.39.2.79. Epub 2014 Mar 21.
Appropriate use of local hemostatic agent is one of the important factors on the prognosis of endodontic microsurgery. However, most investigations to date focus on the hemostatic efficacy of the agents, whereas their biologic characteristics have not received enough attention. The purpose of this paper was to review the biologic response of local hemostatic agents, and to provide clinical guidelines on their use during endodontic microsurgery. Electronic database (PUBMED) was screened to search related studies from 1980 to 2013, and 8 clinical studies and 18 animal studies were identified. Among the materials used in these studies, most widely-investigated and used materials, epinephrine, ferric sulfate (FS) and calcium sulfate (CS), were thoroughly discussed. Influence of these materials on local tissue and systemic condition, such as inflammatory and foreign body reaction, local ischemia, dyspigmentation, delayed or enhanced bone and soft tissue healing, and potential cardiovascular complications were assessed. Additionally, biological property of their carrier materials, cotton pellet and absorbable collagen, were also discussed. Clinicians should be aware of the biologic properties of local hemostatic agents and their carrier materials, and should pay attention to the potential complications when using them in endodontic microsurgery.
局部止血剂的合理使用是牙髓显微外科预后的重要因素之一。然而，迄今为止，大多数研究都集中在这些药剂的止血效果上，而它们的生物学特性尚未得到足够的关注。本文的目的是综述局部止血剂的生物学反应，并提供牙髓显微外科手术中使用这些药剂的临床指南。通过筛选电子数据库（PUBMED）检索1980年至2013年的相关研究，共识别出8项临床研究和18项动物研究。在这些研究中使用的材料中，对研究和使用最广泛的材料肾上腺素、硫酸铁（FS）和硫酸钙（CS）进行了深入讨论。评估了这些材料对局部组织和全身状况的影响，如炎症和异物反应、局部缺血、色素沉着、骨和软组织愈合延迟或增强以及潜在的心血管并发症。此外，还讨论了它们的载体材料棉球和可吸收胶原的生物学特性。临床医生应了解局部止血剂及其载体材料的生物学特性，并在牙髓显微外科手术中使用它们时注意潜在的并发症。
