Hemostatic Agents in Periapical Surgery: A Randomized Study of Gauze Impregnated in Epinephrine versus Aluminum Chloride

J Endod. 2016 Nov;42(11):1583-1587. doi: 10.1016/j.joen.2016.08.005. Epub 2016 Sep 14.


Introduction: Adequate bleeding control is essential for the success of periapical surgery. The aim of this study was to evaluate the effects of 2 hemostatic agents on the outcome of periapical surgery and their relationship with patient and teeth parameters.

Methods: A prospective study was designed with 2 randomized parallel groups, depending on the hemostatic agent used: gauze impregnated in epinephrine (epinephrine group) and aluminum chloride (aluminum chloride group). The analysis of the hemorrhage control was judged before and after the application of the hemostatic agents by the surgeon, and 2 examiners independently recorded it as adequate (complete hemorrhage control) or inadequate (incomplete hemorrhage control).

Results: Ninety-nine patients with a periradicular lesion were enrolled in this study and divided into 2 groups: gauze impregnated in epinephrine in 48 patients (epinephrine group) or aluminum chloride in 51 (aluminum chloride group). In epinephrine group adequate hemostasis was achieved in 25 cases, and in aluminum chloride group it was achieved in 37 cases (P < .05).

Conclusions: The outcome was better in the aluminum chloride group than in the gauze impregnated in epinephrine group.

Keywords: Aluminum chloride; endodontic surgery; epinephrine; hemostasis; hemostatic agents; periradicular surgery.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aluminum Chloride
  • Aluminum Compounds / administration & dosage*
  • Chlorides / administration & dosage*
  • Endodontics / instrumentation
  • Endodontics / methods
  • Epinephrine / administration & dosage*
  • Female
  • Hemostatics / administration & dosage*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Periapical Diseases / drug therapy*
  • Periapical Diseases / surgery*
  • Tooth Root / drug effects
  • Tooth Root / surgery
  • Treatment Outcome
  • Vasoconstrictor Agents / administration & dosage


  • Aluminum Compounds
  • Chlorides
  • Hemostatics
  • Vasoconstrictor Agents
  • Aluminum Chloride
  • Epinephrine