Effect of platelet-rich fibrin versus chitosan-based Axiostat hemostatic agent following dental extraction in cardiac patients on antiplatelet therapy: A comparative study
Kamala Rajendra1, Swetha Vempalli2, Mithileswer Kadiyala3, Vidushi Sharma4, Swetha Karipineni3, Srikanth Gunturu3, Dipak Baliram Patil5
1 Department of Dentistry, ESICMC PGIMSR Medical College, Rajajinagar, Bengaluru, Karnataka, India
2 College of Dentistry, Jazan University, Kingdom of Saudi Arabia
3 Department of Oral and Maxillofacial Surgery, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Vijayawada, Andhra Pradesh, India
4 Department of Pharmacology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India
5 Department of Dentistry, BKL Walawalkar Rural Medical College and Hospital, Chiplun, Maharastra, India
Dr. Vidushi Sharma
Assistant Professor, Department of Pharmacology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), Mullana - 133 207, Ambala, Haryana
Source of Support: None, Conflict of Interest: None
Background: Platelet-rich fibrin (PRF) is a biomaterial that promotes wound healing. It has a fibrinous matrix wherein platelets, pro-inflammatory cytokines, and various growth factors along with few cells are entrapped while Chitosan is a naturally occurring cationic biopolymeric material that is derived from an animal product, chitin. It has demonstrated biological properties which include acceleration in wound healing, hemostasis, enhancement of immunological response, mucosal adhesion by eliciting biological responses, and anti-microbial action.
Aim: The aim of this study was to evaluate the effect of PRF and Axiostat (A chitosan-based product) on hemostasis after tooth extraction among cardiac patients on antiplatelet medication.
Materials and Methods: This prospective study was carried out on 300 patients undergoing tooth extraction. Participants were divided into two categories (n = 150, respectively) as Group I (PRF dressing) and Group II (Axiostat dressing). Time to achieve hemostasis was observed using a stopwatch. Average pain score calculation was performed using visual analog on the 7-day postoperative period. Descriptive statistics were done, and data analysis was performed using the Mann–Whitney U-test. P < 0.5 and < 0.001 were considered statistically significant and extremely significant, respectively.
Results: Average pain score was 1.86 ± 0.06 in Group I and 1.05 ± 0.87 in Group II. Thus, lower postoperative pain was seen with Axiostat dressing. Hemostasis was achieved in Group II participants in 1.25 ± 0.06 min and in 1.89 ± 0.54 min in Group I. P < 0.01 was obtained, although no statistically significant difference in postoperative pain scores (P = 0.8) was seen.
Conclusion: Chitosan is a superior wound dressing material in achieving hemostasis in cardiac patients on antiplatelet medication after tooth extraction.