A Biodegradable Flexible Micro/Nano-Structured Porous Hemostatic Dental Sponge

Abstract

A biodegradable micro/nano-structured porous hemostatic gelatin-based sponge as a dentistry surgery foam was prepared using a freeze-drying method. In vitro function evaluation tests were performed to ensure its hemostatic effect. Biocompatibility tests were also performed to show the compatibility of the sponge on human fetal foreskin fibroblasts (HFFF2) cells and red blood cells (RBCs). Then, 10 patients who required the extraction of two teeth were selected, and after teeth extraction, for dressing, the produced sponge was placed in one of the extracavities while a commercial sponge was placed in the cavity in the other tooth as a control. The total weight of the absorbed blood in each group was compared. The results showed a porous structure with micrometric and nanometric pores, flexibility, a two-week range for degradation, and an ability to absorb blood 35 times its weight in vitro. The prepared sponge showed lower blood clotting times (BCTs) (243.33 ± 2.35 s) and a lower blood clotting index (BCI) (10.67 ± 0.004%) compared to two commercial sponges that displayed its ability for faster coagulation and good hemostatic function. It also had no toxic effects on the HFFF2 cells and RBCs. The clinical assessment showed a better ability of blood absorption for the produced sponge (p-value = 0.0015). The sponge is recommended for use in dental surgeries because of its outstanding abilities.

Keywords: dentistry sponge; gelatin; hemostatic effect; nanomedicines; nanotechnology.

Figure 1

A scheme for the reaction steps.

Figure 2

The process for clinical assessment.

Figure 3

The produced sponge with the dimension of 10 × 10 × 10 mm (a). The SEM image of the sponge (b) and the EDX analysis (c).

Figure 4

FTIR results for gelatin and the produced sponge.

Figure 5

XRD diffraction patterns, gelatin (a), and the prepared sponge (b).

Figure 6

The degradation process of the produced sponge for 2 weeks.

Figure 7

The morphology of RBCs under the light microscope (100×).

Figure 8

The results for CT coagulation time.

Figure 9

The results for blood clotting index (BCI).

Figure 10

The absorption and aggregation of platelets on the produced sponge.

Figure 11

The time points of the fibrin formation process under a light microscope (100×): (a) on the production sponge at the time of 30 s, (b) on the production sponge at the time of 70 s, and (c–j) related to the blood droplet from 180 to 240 s.