From dental adhesives to injectable hemostats: a scoping review of antimicrobial biomaterials for oral soft-tissue bleeding.

Abstract

The management of acute oral hemorrhage in emergency settings is frequently complicated by saliva, high vascularity, and microbial presence. This scoping review maps the emerging field of multifunctional, dental-inspired biomaterials. The objective is to synthesize evidence on injectable materials providing rapid hemostasis and antimicrobial protection, while acknowledging the current transition from laboratory models to clinical applications. Following PRISMA-ScR guidelines and the Population-Concept-Context (PCC) model, we searched Scopus, PubMed, and Web of Science (updated search date: July 10, 2026). No language restrictions were applied. Two authors independently performed screening and data extraction (Cohen's Kappa = 0.88). Review articles provided thematic context, while 13 primary research studies provided data for performance benchmarking. No formal protocol was registered. Analysis of 13 primary studies reveals a shift toward chitosan and gelatin-methacryloyl (GelMA) matrices. Quantitative synthesis showed a 32%-42% reduction in hemostasis time compared with commercial controls [1, 2], primarily in low-pressure models. Antimicrobial zones of inhibition ranged from 10 to 18 mm. Antimicrobial action was primarily validated against planktonic, single-species cultures, with effectiveness against complex oral biofilms yet to be proven. Current evidence supports the application of these materials for minor-to-moderate hemorrhage. Broad application for major arterial trauma remains a future objective requiring longitudinal safety studies on nanoparticle bioaccumulation and dynamic mechanical validation under arterial pressure.