Efficacy of local tranexamic acid treatment for prevention of bleeding after dental procedures: A systematic review and meta-analysis

Abstract

Background/purpose Tranexamic acid (TA) is one of the commonly used local hemostatic agents for dental procedures and a previous study has demonstrated a significantly lower incidence of post-procedural bleeding (PPB) in patients taking warfarin and received local TA treatment after the dental procedures than those who took warfarin and did not receive local TA treatment. However, it is still unknown whether post-procedural local TA treatment can lower the bleeding risk to the same level as individuals who do not take oral anticoagulant (OAC). The current study aimed to compare the PPB risk in patients who took OAC and received local TA treatment after the dental procedures and individuals who did not take OAC and underwent similar dental procedures. Materials and methods We systematically searched primary researches from two databases and four eligible cohort studies were identified. The bleeding incidence was collected from each study and the pooled odds ratio (OR) and 95% confidence interval (CI) of PPB were calculated using Mantel-Haenzel method. Results The analysis revealed a higher risk of PPB in patients who took OAC and received local TA treatment after the dental procedures than individuals who did not take OAC and underwent similar dental procedures with the pooled OR of 2.4, although the pooled effect estimate had a relatively wide 95% CI with non-statistically difference (0.69–8.12). Conclusion This study results serve as a reminder to dentists that the increased risk of PPB in those who took OAC is not entirely resolved by the local TA treatment.

Analysing the effectiveness of topical bleeding care following tooth extraction in patients receiving dual antiplatelet therapy-retrospective observational study

“…The observations presented here are consistent with the findings reported by Bajkin et al who performed tooth extractions without a risk of bleeding and without changing the algorithm of antiplatelet therapy (no interruption of the therapy); they only applied local haemostatic agents [32]. Owattanapanich et al presented data related to efficacy and effectiveness of tranexamic acid in treatment and prevention of post-extraction bleeding in patients using anticoagulant drugs [33]. Napenas et al, based on a review of 15 studies meeting eligibility criteria, assessed the risk of bleeding after dental surgeries performed in patients subject to anti-aggregation therapy and they did not identify a higher risk of clinical complications following tooth extraction in patients using single or dual antiplatelet therapy [21].…”

Analysing the Effectiveness of Topical Bleeding Care Following Tooth Extraction in Patients Receiving Dual Antiplatelet Therapy. Personal Experiences.

“…The observations presented here are consistent with the ndings reported by Bajkin et al who performed tooth extractions without a risk of bleeding and without changing the algorithm of antiplatelet therapy (no interruption of the therapy); they only applied local haemostatic agents [32]. Owattanapanich et al presented data related to e cacy and effectiveness of tranexamic acid in treatment and prevention of post-extraction bleeding in patients using anticoagulant drugs [33]. Napenas et al, based on a review of 15 studies meeting eligibility criteria, assessed the risk of bleeding after dental surgeries performed in patients subject to anti-aggregation therapy and they did not identify a higher risk of clinical complications following tooth extraction in patients using single or dual antiplatelet therapy [21].…”

Insights into idarubicin antimicrobial activity against methicillin-resistant Staphylococcus aureus

“…Thus, the topical use of IDAR may be a better choice compared to systemic use. In the treatment of leukemia, IDAR is typically administered in a dose of 10 ~ 15 mg/m 2 for a couple of days, depending on the regimen where it is being used [41,42]. Mice have an average body weight/surface area ratio of ~3 kg/m 2 .…”