This Week in Dental Implants we wanted to highlight a study that compared Surgical and Gelfoam post-extraction in a group of 40 patients.
The Vital Role of Controlling Bleeding in Extraction Sockets
The formation and stability of blood clots plays a vital role in the successful healing of wounds. In an extraction site, a well-formed blood clot is crucial for preventing infection and promoting proper tissue regeneration. Therefore, techniques that enhance blood clot adhesion and stability can significantly improve the healing outcomes in extraction sites, and help prevent complications like dry socket.
For these reasons, the use of hemostatic agents are crucially important post-extraction. These agents help manage and control bleeding, and aid in blood clot formation by promoting the coagulation process and stabilizing the clot.. This is particularly important for patients who are on anticoagulation therapy, as it allows them to get extractions and continue their medication without interruption. 1,2
Popular Hemostatic Agents
Two of the most popular hemostatic agents are: Surgicel and Gelfoam. Gelfoam is a highly absorbent gelatin sponge prepared from purified porcine skin. Surgicel is composed of oxidized, regenerated cellulose. (Note: Benacel Dental Dressing is substantially equivalent to Surgical and is also made from biocompatible oxidized cellulose and contains no chemical additives).
But which is performs better in extraction sockets? This was the subject of an interesting study, Comparative evaluation of surgicel and gelfoam in controlling post-extraction bleeding in patients on anticoagulant therapy: a clinical study. 3 A total of 40 patients, were divided into two groups based on the type of anticoagulant used, with each patient receiving both Gelfom and Surgicel on different areas of the site.
Case Photos
Case Photos provided by: Al-Suliman W, Wehbeh I, Al-Hafyan S. Comparative evaluation of surgicel and gelfoam in controlling post-extraction bleeding in patients on anticoagulant therapy: a clinical study. BMC Oral Health. 2025 Sep 1;25(1):1393.
A After extraction, B Bandage application, C After three days, D After seven days
Conclusion: Surgical (Oxidized Cellulose, Benacel) Performed Better In This Particular Study
The authors concluded:
The results demonstrate that Surgicel provides superior hemostatic control compared to Gelfoam, as it helps reduce delayed bleeding, accelerates gingival tissue healing, and minimizes pain, making it the preferred treatment option for this patient group
Note, however, that the results are not a definitive recommendation, because there are significant limitations to the study. Notably, the study focused on a high-risk population that may not be representative of the general population. As well, there was a lack of a suture-only control group. Finally, the assessment of postoperative pain was not ideal as both surgical sites were treated in a single session, and patients may have experienced difficulty in localizing discomfort to a specific side. Nevertheless, despite these limitations, the study is quite interesting and reveals some very important differences between Gelfoam and Surgicel. If you use either of this materials, the entire study is well worth a read.
Learn more about Benacel Dental Dressing (Comparable to Surgicel)
References
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Vassallo M, Zamberlin J, Roig MD, Macchi R, Aguilar JE. Efficacy of Local Hemostatic Management in Implant Surgery in Anticoagulated Patients on Warfarin: A Randomized Clinical Study. Int J Oral Maxillofac Implants. 2023 May, Jun;38(3):545-552. doi: 10.11607/jomi.9846. PMID: 37279226.
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Gómez-Moreno G, Aguilar-Salvatierra A, Fernández-Cejas E, Delgado-Ruiz RA, Markovic A, Calvo-Guirado JL. Dental implant surgery in patients in treatment with the anticoagulant oral rivaroxaban. Clin Oral Implants Res. 2016 Jun;27(6):730-3. doi: 10.1111/clr.12653. Epub 2015 Jun 15. PMID: 26073481.
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Al-Suliman W, Wehbeh I, Al-Hafyan S. Comparative evaluation of surgicel and gelfoam in controlling post-extraction bleeding in patients on anticoagulant therapy: a clinical study. BMC Oral Health. 2025 Sep 1;25(1):1393. doi: 10.1186/s12903-025-06777-7.