Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

25 questions · 26 findings · 3 reviews · Oral and maxillofacial surgery · All outcomes

No studies found 13 · 50%GRADE not reported 7 · 26.9%Very low 3 · 11.5%Low 0 · 0%Moderate 3 · 11.5%High 0 · 0%

Low‐level laser therapy vs Placebo (sham) laser therapy

Patient-reported altered sensation (spontaneous or evoked: anaesthesia/paraesthesia/dysaesthesia/hyperalgesia/allodynia) · Patients of any age in any setting requiring intervention for iatrogenic injury to the inferior alveolar or lingual nerve

It is very uncertain whether low-level laser therapy (photon-plus GaAlAs diode laser; 70 mW… changes patient-reported altered sensation (spontaneous or evoked:… compared with placebo (sham) laser therapy (very low certainty).

2 findings from 1 review

Low‐level laser therapy vs Placebo (sham) laser therapy

Somatosensory evoked potentials · Patients of any age in any setting requiring intervention for iatrogenic injury to the inferior alveolar or lingual nerve

The review found no eligible studies for this question.

1 finding from 1 review

Low‐level laser therapy vs Placebo (sham) laser therapy

Mechanosensory perception (load in grams to elicit sensation; Semmes Weinstein monofilaments) · Patients of any age in any setting requiring intervention for iatrogenic injury to the inferior alveolar or lingual nerve

Low-level laser therapy (photon-plus GaAlAs diode laser; 70 mW… led to higher mechanosensory perception (load in grams to elicit sensation; Semmes… compared with placebo (sham) laser therapy; GRADE not reported.

1 finding from 1 review

Low‐level laser therapy vs Placebo (sham) laser therapy

Thermosensory (thermal) perception · Patients of any age in any setting requiring intervention for iatrogenic injury to the inferior alveolar or lingual nerve

Low-level laser therapy (photon-plus GaAlAs diode laser; 70 mW… showed no clear difference in thermosensory (thermal) perception compared with placebo (sham) laser therapy; GRADE not reported.

1 finding from 1 review

Low‐level laser therapy vs Placebo (sham) laser therapy

Patient satisfaction · Patients of any age in any setting requiring intervention for iatrogenic injury to the inferior alveolar or lingual nerve

The review found no eligible studies for this question.

1 finding from 1 review

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

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes pain (continuous, VAS 0-10 cm, 7th day) compared with placebo (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 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

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