Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

275 questions · 299 findings · 21 reviews · Oral and maxillofacial surgery

No studies found 50 · 16.7%GRADE not reported 207 · 69.2%Very low 17 · 5.7%Low 20 · 6.7%Moderate 5 · 1.7%High 0 · 0%

Education vs usual care

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review

CBT vs inactive control (usual care care, attention control, waitlist)

Disability caused by pain at follow-up · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) showed no clear difference in pain disability at treatment completion compared with usual care, waiting list or no treatment (control) (low certainty).

2 findings from 1 review

CBT vs inactive control (usual care care, attention control, waitlist)

Mental distress · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) showed no clear difference in psychological distress at follow-up compared with usual care, waiting list or no treatment (control) (low certainty).

2 findings from 1 review

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

Lower incisor inclination (lingual tipping and retrusion) · Children (approximately 11 years or older) with compromised mandibular first permanent molars

Bilateral lower first permanent molar extraction was associated with lingual tipping and retrusion of the lower incisors 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 standard local care

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 standard care (usual local haemostatic measures: gelatin sponge and…; 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 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 standard local care

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)… showed no clear difference in number of participants with postoperative bleedings requiring… compared with standard care (usual local haemostatic measures: gelatin sponge and… (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

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

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

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

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

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

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

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