Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

211 questions · 253 findings · 24 reviews · Oral and maxillofacial surgery

No studies found 32 · 12.6%GRADE not reported 183 · 72.3%Very low 25 · 9.9%Low 7 · 2.8%Moderate 6 · 2.4%High 0 · 0%

Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo)

Number of immediate (less than 24 hours) and delayed (24 hours to 10 days) postoperative bleeding episodes requiring intervention · People with haemophilia (A or B) undergoing minor oral surgery or dental extractions

The review found no eligible studies for this question.

1 finding from 1 review

Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo)

Side effects or other adverse events · People with haemophilia (A or B) undergoing minor oral surgery or dental extractions

Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic… showed no clear difference in side effects or other adverse events compared with placebo, no intervention or usual care (with or without placebo) (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

Number of thromboembolic complications · 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

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

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

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

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

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

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 participants with postoperative bleedings 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)… probably leads to lower number of participants with postoperative bleedings requiring… compared with placebo (placebo solution/mouthwash) (moderate 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

Amount of postoperative blood loss (mL) · 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