Comparative Evaluation of Local Hemostatic Agents in Minor Oral Surgical Procedures: A Randomized Clinical Trial.

Background Achieving effective hemostasis is a critical aspect of minor oral surgeries. This study aimed to compare the efficacy of Botroclot, chitosan, adrenaline, and tranexamic acid in achieving hemostasis and preventing postoperative bleeding, thereby identifying the most clinically efficient hemostatic method for routine use in oral surgery. Methodology A parallel-group randomized controlled clinical trial was conducted at the Department of Oral and Maxillofacial Surgery between February and April 2025. A total of 60 healthy patients aged 20-50 years who required extraction of the upper or lower first or second molars were randomly allocated into five groups (n = 12). Group 1 was treated with Botroclot. Group 2 was treated with chitosan dressing. Group 3 was treated with adrenaline. Group 4 was treated with tranexamic acid. Group 5 (control) was treated with pressure gauze soaked in normal saline. All procedures were performed under local anesthesia. The hemostatic agent was applied to the socket post-extraction, and the time to achieve hemostasis (observation time) was recorded. Preoperative bleeding time, clotting time, and the incidence of postoperative rebleeding were also evaluated. Statistical analysis was conducted using one-way analysis of variance (ANOVA), Tukey's post-hoc test, and Pearson's correlation. Statistical significance was set at p-values <0.05. Results All groups were comparable at baseline. The shortest mean observation time was recorded in the Botroclot group, followed by that in the tranexamic acid and chitosan groups. The longest was in the control group (1.80 ± 0.41 minutes). ANOVA revealed a statistically significant difference in observation time among the groups (p = 0.001). Post-hoc analysis revealed significant differences, particularly between the Botroclot, adrenaline, and pressure gauze groups. No postoperative complications or bleeding events were noted. Significant correlations between bleeding and observation time were observed in the adrenaline, tranexamic acid, and control groups. Conclusions Botroclot demonstrated the most rapid hemostatic effect, followed by tranexamic acid and chitosan. Pressure gauze and adrenaline were less effective. These findings support the use of Botroclot and tranexamic acid as efficient hemostatic agents in minor oral surgery.