What do systematic reviews say?

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes trismus (dichotomous, 7th day) compared with placebo (very low certainty).

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes

  7th day
  RR 0.77 [0.42, 1.41]
  3 studies · 199 participants
  Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes fever (6th-7th day) compared with placebo (very low certainty).

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes

  6th to 7th day
  RR 0.66 [0.24, 1.79]
  4 studies · 475 participants
  Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs Placebo

The review found no eligible studies for this question.

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes
  No studies in general dental practice for removal of decayed teeth. PUB3 added one routine intra-alveolar extraction trial and one complex oral surgery trial (2 of 23 non-third-molar), but the single intra-alveolar…
  0 studies
  No studies found

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

The review found no eligible studies for this question.

• Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… 2019 · Cochrane All outcomes
  This outcome was not reported in either of the trials.
  0 studies
  No studies found

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs High-content fluoride toothpaste (1350 ppm)

• Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy 2019 · Cochrane All outcomes

  14 to 36 months
  Adverse effects were an outcome of interest in the study conducting this comparison, however no mention was made of the presence or absence of any adverse events
  1 study · 220 participants
  Very low

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

The review found no eligible studies for this question.

• Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… 2019 · Cochrane All outcomes
  No randomised or quasi-randomised controlled trials in people with Von Willebrand disease met the inclusion criteria; no eligible VWD trials were identified.
  0 studies
  No studies found

Hyperbaric oxygen therapy (HBO) following extractions vs penicillin G

It is very uncertain whether hyperbaric oxygen therapy (HBO) following extractions changes incidence of ORN compared with perioperative antibiotic prophylaxis (penicillin G) following… (very low certainty).

• Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy 2019 · Cochrane All outcomes

  6 months
  RR 0.18 [0.43, 0.76]
  1 study · 74 participants
  Very low

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

• Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… 2019 · Cochrane All outcomes
  Only reported in the Walsh (EACA) trial: in none of the 31 included participants was blood transfusion required.
  1 study · 31 participants
  GRADE not reported

Combined HBO and perioperative antibiotics prior to dental implant therapy vs antibiotics alone

• Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy 2019 · Cochrane All outcomes

  1 year
  This comparison was only made in 1 study which reported no serious adverse events associated with HBO therapy. Quality of life measures (oral status, functioning, satisfaction) showed emotional functioning and pain…
  1 study · 26 participants
  Very low

Hyperbaric oxygen therapy (HBO) following extractions vs penicillin G

• Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy 2019 · Cochrane All outcomes

  6 months
  Adverse effects were an outcome of interest in the study conducting this comparison, however no mention was made of the presence or absence of any adverse events
  1 study · 74 participants
  Very low

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

• Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… 2019 · Cochrane All outcomes
  Mean fall in haemoglobin. Forbes (TXA): 1.4 g/100 mL (placebo) vs 0.3 g/100 mL (TXA). Walsh (EACA): 6.3% (placebo, both centres) vs 3.9% and 3.7% (EACA, centres 1 and 2); differences not significant. Reported in…
  2 studies · 59 participants
  GRADE not reported

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

The review found no eligible studies for this question.

• Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… 2019 · Cochrane All outcomes
  This outcome was not reported in either of the trials.
  0 studies
  No studies found

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

• Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… 2019 · Cochrane All outcomes
  Reported in both trials in different ways. Forbes (TXA): mean units of replacement therapy per root extracted 617 IU (range 0 to 15,800) in 11 placebo participants versus 30 IU and 65 IU per root in 2 TXA participants…
  2 studies · 59 participants
  GRADE not reported

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

The review found no eligible studies for this question.

• Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… 2019 · Cochrane All outcomes
  This outcome was not reported in either of the trials.
  0 studies
  No studies found

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

Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic… probably leads to lower number of postoperative bleeding episodes requiring intervention compared with placebo, no intervention or usual care (with or without placebo) (moderate certainty).

• Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… 2019 · Cochrane All outcomes

  Up to 10 days postoperative
  RD -0.57 [-0.76, -0.37]
  2 studies · 59 participants
  Moderate

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

• Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… 2019 · Cochrane All outcomes
  Only reported in the Forbes (TXA) trial: over five-day follow-up, mean blood loss per participant 84.1 mL (range 4 to 323) in the placebo group (n=14) versus 61.2 mL (range 1 to 749) in the TXA group (n=14), P = 0.02.
  1 study · 28 participants
  GRADE not reported

PRP (platelet-rich plasma) in cellulose foam placed in extraction socket vs placebo, no treatment or surveillance only

It is very uncertain whether PRP (platelet-rich plasma) in cellulose foam placed in extraction… changes incidence of ORN compared with no treatment/placebo (cellulose foam only) placed in extraction socket (very low certainty).

• Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy 2019 · Cochrane All outcomes

  5-year follow-up
  OR 3.32 [0.58, 19.09]
  1 study · 44 participants
  Very low

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs High-content fluoride toothpaste (1350 ppm)

• Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy 2019 · Cochrane All outcomes

  14 to 36 months
  This comparison was only made in 1 study, which showed no difference between the 2 interventions: no patients in either group developed ORN (12- to 36-month follow-up) (0/99 in the fluoride gel group and 0/91 in the…
  1 study · 220 participants
  Very low

PRP (platelet-rich plasma) in cellulose foam placed in extraction socket vs placebo, no treatment or surveillance only

• Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy 2019 · Cochrane All outcomes

  2 weeks to 12 months
  This comparison was only made in 1 study: mean pain scores at 2 weeks, 2, 6, 9, and 12 months showed no 'significant' differences between the 2 groups (self-reported Likert scale 1 to 10; difference at 2 weeks P =…
  1 study · 44 participants
  Very low

Combined HBO and perioperative antibiotics prior to dental implant therapy vs antibiotics alone

It is very uncertain whether combined HBO and perioperative antibiotics prior to dental implant… changes incidence of ORN compared with antibiotics alone prior to dental implant therapy (very low certainty).

• Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy 2019 · Cochrane All outcomes

  1 year
  RR 3.00 [0.14, 65.16]
  1 study · 26 participants
  Very low