Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

33 questions · 33 findings · 3 reviews · Oral and maxillofacial surgery

No studies found 10 · 30.3%GRADE not reported 12 · 36.4%Very low 0 · 0%Low 1 · 3%Moderate 6 · 18.2%High 4 · 12.1%

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

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

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) vs paracetamol

Participant‐reported pain relief of 50% or greater · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) leads to higher proportion of patients with >50% maximum pain relief (TOTPAR) over 6… compared with paracetamol (acetaminophen) (single postoperative oral dose; 600 mg… (high certainty).

1 finding from 1 review

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) vs paracetamol

Proportion of patients with >50% maximum pain relief (TOTPAR) over 2 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) leads to higher proportion of patients with >50% maximum pain relief (TOTPAR) over 2… compared with paracetamol (acetaminophen) (single postoperative oral dose; 600 mg… (high certainty).

1 finding from 1 review

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) vs paracetamol

Patients not using rescue medication at 6 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) leads to higher patients not using rescue medication at 6 hours compared with paracetamol (acetaminophen) (single postoperative oral dose; 600 mg… (high certainty).

1 finding from 1 review

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) vs paracetamol

Use of rescue medication · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) led to higher patients using rescue medication at 8 hours compared with paracetamol (acetaminophen) (single postoperative oral dose; 600 mg…; GRADE not reported.

1 finding from 1 review

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) vs paracetamol

Adverse events · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…
1 finding from 1 review

Combined paracetamol plus ibuprofen in a single tablet (e.g. paracetamol 1000 mg/ibuprofen 400 mg or 500/200 mg) vs Single drugs given separately (paracetamol 1000 mg or ibuprofen 400 mg)

Proportion of patients with >50% maximum pain relief (TOTPAR) over 2 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

Combined paracetamol plus ibuprofen in a single tablet (e.g.… showed no clear difference in proportion of patients with >50% maximum pain relief (TOTPAR) over 2… compared with single drugs given separately (paracetamol 1000 mg or ibuprofen 400… (moderate certainty).

1 finding from 1 review

Combined paracetamol plus ibuprofen in a single tablet (e.g. paracetamol 1000 mg/ibuprofen 400 mg or 500/200 mg) vs Single drugs given separately (paracetamol 1000 mg or ibuprofen 400 mg)

Adverse events · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…
1 finding from 1 review

Combined paracetamol plus ibuprofen in a single tablet (e.g. paracetamol 1000 mg/ibuprofen 400 mg or 500/200 mg) vs Single drugs given separately (paracetamol 1000 mg or ibuprofen 400 mg)

Participant‐reported pain relief of 50% or greater · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

Combined paracetamol plus ibuprofen in a single tablet (e.g.… probably leads to higher proportion of patients with >50% maximum pain relief (TOTPAR) over 6… compared with single drugs given separately (paracetamol 1000 mg or ibuprofen 400… (moderate certainty).

1 finding from 1 review

Combined paracetamol plus ibuprofen in a single tablet (e.g. paracetamol 1000 mg/ibuprofen 400 mg or 500/200 mg) vs Single drugs given separately (paracetamol 1000 mg or ibuprofen 400 mg)

Patients not using rescue medication at 8 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

Combined paracetamol plus ibuprofen in a single tablet (e.g.… leads to higher patients not using rescue medication at 8 hours compared with single drugs given separately (paracetamol 1000 mg or ibuprofen 400… (high certainty).

1 finding from 1 review