Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

779 questions · 866 findings · 43 reviews · Oral and maxillofacial surgery

No studies found 188 · 21.7%GRADE not reported 548 · 63.3%Very low 81 · 9.4%Low 37 · 4.3%Moderate 8 · 0.9%High 4 · 0.5%

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo mouthwash

Number of minor postoperative bleeding episodes · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and all ages; all four…

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA)… showed no clear difference in number of minor postoperative bleeding episodes compared with placebo (placebo solution/mouthwash); GRADE not reported.

1 finding from 1 review

Maxillary distraction osteogenesis vs Orthognathic surgery (conventional Le Fort I osteotomy)

Speech: resonance (hypernasality) (deterioration/improvement) · Adolescents or adults (15 years or older) with an established diagnosis of complete cleft lip and alveolar process, or complete unilateral…

It is very uncertain whether maxillary distraction osteogenesis changes speech: resonance (hypernasality) (deterioration/improvement) compared with orthognathic surgery (conventional Le Fort I osteotomy) (very low certainty).

1 finding from 1 review

Extraction of a maxillary first permanent molar vs Extraction of a mandibular first permanent molar

Spontaneous space closure · Children aged 5 to 15 years undergoing first permanent molar extraction

Spontaneous post-extraction space closure did not differ significantly between the maxilla and mandible (pooled OR 2.06, 95% CI 0.46 to 9.28; 3 studies; I2 = 72%); ungraded.

1 finding from 1 review

Maxillary distraction osteogenesis vs Orthognathic surgery (conventional Le Fort I osteotomy)

Clinical morbidities (adverse effects) · Adolescents or adults (15 years or older) with an established diagnosis of complete cleft lip and alveolar process, or complete unilateral…
1 finding from 1 review

Bilateral extraction of compromised mandibular first permanent molars vs Age- and gender-matched non-extraction controls

Skeletal development (occlusal plane rotation, facial height) · Children (approximately 11 years or older) with compromised mandibular first permanent molars

Bilateral lower first permanent molar extraction was associated with counter-clockwise rotation of the occlusal plane and a mild decrease in lower anterior face height in one case-control study; ungraded.

1 finding from 1 review

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo mouthwash

Bleeding duration (minutes, all types of bleeding, minor and major) · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and all ages; all four…

The review found no eligible studies for this question.

1 finding from 1 review

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo mouthwash

Adverse effects requiring withdrawal/discontinuation of study medication · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and all ages; all four…

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA)… showed no clear difference in side effects or other adverse events requiring withdrawal compared with placebo (placebo solution/mouthwash) (moderate certainty).

1 finding from 1 review

Maxillary distraction osteogenesis vs Orthognathic surgery (conventional Le Fort I osteotomy)

Psychological status: social self-esteem (Culture-Free Self-Esteem Inventory subset); also general self-esteem and Social Avoidance and Distress Scale · Adolescents or adults (15 years or older) with an established diagnosis of complete cleft lip and alveolar process, or complete unilateral…
1 finding from 1 review

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo mouthwash

Change in haemoglobin level from baseline · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and all ages; all four…

The review found no eligible studies for this question.

1 finding from 1 review

Antifibrinolytic agents (tranexamic acid (TXA) or epsilon aminocaproic acid (EACA)) vs Placebo, no intervention, or usual care

Outcome not reported · People on continuous direct oral anticoagulant (DOAC) treatment undergoing oral or dental procedures

The review found no eligible studies for this question.

1 finding from 1 review

Early extraction of a compromised first permanent molar vs Contralateral non-extraction side (same patient)

Development and eruption of the second permanent molar · Children aged 5 to 15 years with a compromised first permanent molar

Root closure and eruption of the second permanent molar appeared accelerated on the extraction side in a single case-control study; ungraded and not statistically tested.

1 finding from 1 review

Any surgical or non-surgical technique or material used for the treatment of post-extraction bleeding vs Placebo, no treatment, or another active antifungal intervention

Discomfort associated with the procedure · People of any age and either gender with post-extraction bleeding, regardless of type of teeth (anterior or posterior, mandibular or…

The review found no eligible studies for this question.

1 finding from 1 review

Early extraction of a compromised mandibular first permanent molar vs Contralateral non-extraction side (same patient)

Development and eruption of the third molar · Children aged 5 to 15 years with a compromised first permanent molar

Development and eruption of the third molar appeared accelerated after early first permanent molar extraction in two studies (e.g., eruption OR 2.86, 95% CI 1.37 to 5.96); ungraded.

1 finding from 1 review

Maxillary distraction osteogenesis vs Orthognathic surgery (conventional Le Fort I osteotomy)

Midfacial soft tissue changes (facial profile landmarks: pronasale, subnasale, stomion superius, labrale superius) · Adolescents or adults (15 years or older) with an established diagnosis of complete cleft lip and alveolar process, or complete unilateral…

Maxillary distraction osteogenesis showed no clear difference in midfacial soft tissue changes (facial profile landmarks: pronasale,… compared with orthognathic surgery (conventional Le Fort I osteotomy); GRADE not reported.

1 finding from 1 review

Any surgical or non-surgical technique or material used for the treatment of post-extraction bleeding vs Placebo, no treatment, or another active antifungal intervention

Adverse events · People of any age and either gender with post-extraction bleeding, regardless of type of teeth (anterior or posterior, mandibular or…

The review found no eligible studies for this question.

1 finding from 1 review

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo mouthwash

Major bleeding, requiring transfusion of packed red blood cells · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and all ages; all four…

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA)… showed no clear difference in major bleeding requiring transfusion of packed red blood cells compared with placebo (placebo solution/mouthwash); GRADE not reported.

1 finding from 1 review

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo mouthwash

Number of immediate (less than 24 hours) and delayed (24 hours to 10 days) postoperative bleeding episodes requiring intervention · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and all ages; all four…

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA)… led to lower number of immediate and delayed postoperative bleeding episodes… compared with placebo (placebo solution/mouthwash); GRADE not reported.

1 finding from 1 review

Maxillary distraction osteogenesis vs Orthognathic surgery (conventional Le Fort I osteotomy)

Velopharyngeal function (complete velopharyngeal closure; deterioration/improvement) · Adolescents or adults (15 years or older) with an established diagnosis of complete cleft lip and alveolar process, or complete unilateral…

It is very uncertain whether maxillary distraction osteogenesis changes velopharyngeal function (complete velopharyngeal closure;… compared with orthognathic surgery (conventional Le Fort I osteotomy) (very low certainty).

1 finding from 1 review

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo mouthwash

Any postoperative complication except bleeding (e.g. wound infection) · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and all ages; all four…

Antifibrinolytic therapy - locally-applied tranexamic acid (TXA)… showed no clear difference in any postoperative complication except bleeding (e.g. wound infection) compared with placebo (placebo solution/mouthwash); GRADE not reported.

1 finding from 1 review