Insisiva Dental Journal: Majalah Kedokteran Gigi Insisiva, 11(1), May 2022, 26-33 26 Research Article The Effect of Chitosan-Gelfoam Cacao Pod Husk on Wound Epithelial Thickness in the Post-Extraction Tooth with Anticoagulant Therapy Astika Swastirani 1 *, Fiorina Divasinta Mirelia Marsudi 2 1 Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Universitas Brawijaya, Jl. Veteran, Malang, 65145, Indonesia 2 Faculty of Dentistry, Universitas Brawijaya, Jl. Veteran, Malang, 65145, Indonesia Received date: April 4 th , 2022; revised date: May 22 th , 2022; accepted: May 24 th , 2022 DOI: 10.18196/di.v10i1.14408 Abstract Tooth extraction is removing a tooth from its socket when it cannot be restored. Tooth extraction performed in patients on anticoagulant therapy can increase the risk of excessive bleeding. Therefore, a local hemostatic agent is needed to accelerate the hemostasis process and reduce the risk of tooth extraction complications in anticoagulant users. This study aims to determine the effect of chitosan-gelfoam extract of cacao pod husk to increase epithelial thickness in the post-extraction socket of male Wistar rats with anticoagulant therapy. This research used quantitative data collection techniques on 24 male Wistar rats who were given anticoagulant therapy. It was divided into eight groups: negative control group H+3, negative control group H+7, positive control with oral tranexamic acid therapy H+3, positive control with oral tranexamic acid therapy H+7, treatment 1 with 1 ml chitosan-gelfoam cacao pod husk extract therapy H+3, treatment 1 with 1 ml chitosan-gelfoam cacao pod husk H+7, treatment 2 with 10 ml chitosan-gelfoam cacao pod husk H+3, and treatment 2 with 10 ml chitosan- gelfoam cacao pod husk H+7. The test animals were decapitated on the 3rd and 7th day. The histology preparations, observations, and statistical tests were then carried out. The statistical tests showed that chitosan gelfoam extract of cacao pod husk with doses of 1.6% and 15% extract of cacao pod husk was able to replace the effectiveness of tranexamic acid. The 15% dose had better significance than the 1.6% dose. This research is expected to contribute to the farmers’ welfare and the cacao industry by converting cacao pod waste into helpful medicine. Keywords: anticoagulant; cacao pod husk; chitosan-gelfoam; epithelium; tooth extraction INTRODUCTION According to a survey from the International Collaborative Partnership for the Study of Atrial Fibrillation (INTERAF), the use of anticoagulants increased until 2016. 1 Anticoagulants can inhibit platelet aggregation and disrupt wound healing. Thus, special treatment is needed for actions that cause bleeding. Heparin is one of the most commonly used anticoagulants. This drug acts as a factor Xa inhibitor to inhibit blood clotting. 2,3 One of the dental procedures that cause bleeding is tooth extraction. Tooth extraction is the act of removing a tooth from its socket if it cannot * Corresponding author, e-mail: drgrani_pm@ub.ac.id be restored. The ideal tooth extraction is the extraction of a tooth or tooth root that is intact without causing pain, with minimal trauma to the supporting tissue. The extraction wound will usually heal and not cause complications. 4,5 As a result of tooth extraction, the injured tissue will undergo a healing process called re-epithelialization. Re-epithelialization is an important step in the healing of tooth socket wounds. Re- epithelialization plays a role in restoring tissue when a wound occurs after tooth extraction. 6,7 Indonesia is a country rich in marine products. Chitosan is material from