Tanya Suwat, Patcharanuchat Piyachat, Sattayut Sajee
Lasers in Dentistry Research Group, Khon Kaen University, Nai Mueang, Khon Kaen, 40002, Thailand.
Graduate School, Faculty of Dentistry, Khon Kaen University, Nai Mueang, Khon Kaen, 40002, Thailand.
F1000Res. 2025 Apr 7;13:1043. doi: 10.12688/f1000research.155330.1. eCollection 2024.
Currently, there is no objective and quantified measurement for detecting blood clots during extraction socket hemostasis. It has relied solely on clinical observation, even when conducting clinical research by using extraction sockets as samples. This study aimed to assess the in vitro reliability and clinical-relevant validity of a new objective measurement providing quantified data called blood clot detection (BCD) using a standard capillary tube.
The in vitro part of the study was conducted using surplus blood samples from ten healthy participants. Two identical sets of blood samples in simulation reservoirs mimicking bleeding sockets were prepared for reliability tests. Then, the capillary tubes were concurrently placed in the reservoirs. The blood-filled distances were measured. The part of clinical-relevant validity study was conducted in sixteen extraction sockets from each healthy participant. Clinical observation and BCD measurement were evaluated by two calibrated assessors. The total duration of the assessment was a 30-minute.
The distances of the blood-filled capillary tube were decreased by time. Test and retest reliability analysis of the BCD measurement showed an excellent intraclass correlation coefficient of 0.980 (0.968 to 0.988). The medians of blood-filled distance categorized by clinical observation into active bleeding, sluggish oozing, and clot formation were 13.0 mm (Q1 = 11.7, Q3 = 13.8), 5.6 mm (Q1 = 4.3, Q3 = 7.0), and 0.9 mm (Q1 = 0.5, Q3 = 1.3), respectively. The blood-filled distance of the clot formation group was significantly less than the active bleeding and sluggish oozing (p<0.001). Therefore, the BCD measurement also significantly indicated the completion of extraction socket hemostasis.
A distance of blood-filled in capillary tube of 0.9 mm from the BCD measurement significantly ensured complete clot formation. The BCD measurement proved to be a quantified tool for objectively measuring hemostasis of bleeding socket.
目前，在拔牙创止血过程中，尚无用于检测血凝块的客观且量化的测量方法。即使在以拔牙创为样本进行临床研究时，也完全依赖临床观察。本研究旨在评估一种新的客观测量方法的体外可靠性和临床相关有效性，该方法使用标准毛细管提供名为血凝块检测（BCD）的量化数据。
本研究的体外部分使用了来自10名健康参与者的剩余血样。在模拟拔牙创出血的储液器中制备两组相同的血样用于可靠性测试。然后，将毛细管同时放入储液器中。测量血液填充的距离。临床相关有效性研究部分在每位健康参与者的16个拔牙创中进行。由两名经过校准的评估者对临床观察和BCD测量进行评估。评估的总时长为30分钟。
血液填充毛细管的距离随时间减少。BCD测量的重测信度分析显示组内相关系数极佳，为0.980（0.968至0.988）。根据临床观察分为活动性出血、缓慢渗血和血凝块形成的血液填充距离中位数分别为13.0毫米（第一四分位数=11.7，第三四分位数=13.8）、5.6毫米（第一四分位数=4.3，第三四分位数=7.0）和0.9毫米（第一四分位数=0.5，第三四分位数=1.3）。血凝块形成组的血液填充距离显著小于活动性出血和缓慢渗血组（p<0.001）。因此，BCD测量也显著表明拔牙创止血已完成。
BCD测量中毛细管内血液填充距离为0.9毫米可显著确保血凝块完全形成。BCD测量被证明是一种客观测量拔牙创出血止血情况的量化工具。
