Cytotoxicity of hemostatic agents on the human gingival fibroblast

Achieving of moisture control especially gingival bleeding control is great challenge in clinical practice. Various hemostatic agents and techniques have been promoted for bleeding control during dental operation. But few studies have focused on the cytotoxicity of hemostatic solutions.

The aim of this study was to evaluate cytotoxic effect of hemostatic agents on human gingival fibroblast cells by using real-time cell analysis method.

Two hemostatic solutions, Hemoban (Sultan Healthcare, Hackensack, NJ, USA) and Hemasatic Solutions (W.P. Dental, Hamburg, Germany) that includes mainly aluminum chloride were used with different concentration. Gingival fibroblasts were isolated from gingival connective tissue during crown lengthening surgery of systemically healthy subjects. Gingival fibroblasts were maintained with Dulbecco's modified eagle medium containing 10% fetal bovine serum. A real-time cell analyzer (RT-CES, xCELLigence; Roche Applied Science, Mannheim, Germany, and ACEA Biosciences, San Diego, CA, USA) was used to evaluate cell survival. After seeding 200 mL of the cell suspensions into the wells (10,000 cells/well) of the E-plate 96, gingival fibroblasts were treated with hemostatic solutions (1/2, 1/4 and 1/8 dilutions) and monitored every 15 minutes for 72 hours. For the proliferation experiments, the statistical analyses used were 1-way analysis of variance (ANOVA) and Tukey HSD multiple comparisons tests.

According to statistically analysis, when evaluated at 48 and 72 hours, there were significant differences between the cell indexes of the control and all hemostatic agents groups (p < 0.001). Agent reduced cell index value significantly when compared to untreated control group.

The results indicate that using of Hemoban or Hemostatic Solutions as astringent solutions have a significant cytotoxic effect on gingival fibroblast cells.