An adequate hemostasis is of utmost importance for the success of apical surgery, because it not only improves operative visibility, but also provides a dry environment within the bony crypt, ideal for an adequate retrograde obturation. This article describes a new approach for the successful management of hemostasis during apical surgery through the use of autoclavable polytetrafluoroethylene (PTFE) strips as an adjunct to epinephrine-impregnated gauze as the hemostatic material. The treatment protocol entailed the application of PTFE strips as an adjunct to epinephrine-impregnated gauze in the apical microsurgery approach, using mineral trioxide aggregate as retrograde obturation material and advanced platelet-rich fibrin plus (A-PRF+) membranes as filling material of the bony crypt. Asynergistic effect of the application of PTFE strips adjunct to epinephrine- impregnated gauze was found, yielding good intraoperative visualization and hemostasis. PTFE strips work as a mechanical barrier, and the material is easily adapted to the bony crypt size and feature by compression. Moreover, PTFE strips are easy to remove without leaving residues that may impair healing. PTFE strips and epinephrine-impregnated gauze demonstrated a good synergistic effect on hemostasis. PTFE strips are a simple, innocuous and cheap means of enhancing bleeding control during apical surgery.
KeywordsApical surgery; PTFE; hemostatic agent; oral surgery; advanced plateletrich fibrin plus.