The effect of haemostatic agents on early healing of the extraction socket

Aim This study aims to explore the effect of two commercially available haemostatic agents (i.e., collagen sponge and oxide cellulose) on early healing of the extraction socket. Material and Methods In a murine model, bilateral maxillary first molars were extracted and the sockets were filled with or without haemostatic agents. Histology, histomorphometry and immunostaining assays were performed on samples harvested on postextraction day 1, 3, 7 and 14. In vitro studies were also designed to investigate the effect of agents on the dynamics of pH and viability of cells. Results Early socket healing was delayed by both agents but with different patterns. The migration of cells was impeded by oxide cellulose on postextraction day 1 compared with the collagen and the control group. The proliferation and osteogenic differentiation of cells were delayed by both materials. Moreover, apoptosis of periodontal ligament cells was present in the haemostatic agent groups. These effects are attributed to the compression to periodontal ligament by both agents, the acidic niche caused by oxide cellulose, and the intense foreign body reaction and inflammatory response caused by the agents. Conclusions The placement of haemostatic agents delay the early extraction socket healing via different biological mechanism.