Considerable part of the dental procedures is associated with postoperative bleeding, which is usually mild and does not pose a serious risk to the patient. Patients with coagulation disorders (e.g. haemophilia or other coagulopathies, anticoagulant therapy, etc.) have an increased risk of bleeding. Even minimal invasive manipulations can cause prolonged bleeding which could prevent completion of the procedure, compromise wound healing, or even be life-threatening.
To analyze data from publications exploring the efficacy and safety of local administration of tranexamic acid and its use to control surgical and postoperative bleeding in dental practice in patients with bleeding disorders.
A systematic search was conducted in PubMed database for all available publications until June 2018, describing tranexamic acid as a haemostatic agent, used in dental treatment of patients with bleeding disorders.
It is approved that in patients taking anticoagulants, after scaling and root planning or oral surgery, washing the operative field with tranexamic acid followed by oral rinses during the first week after the procedure is safe and can reduce the risk of bleeding. 5% tranexamic acid solution is local haemostatic agent with advantages such as low risk of antibody development and contamination of blood products as well as low cost. In controlled studies, the use of a diluted 5% aqueous solution of tranexamic acid (Medocapron®) significantly reduces post-operative bleeding episodes in patients on anticoagulant therapy.
All available data confirms that tranexamic acid can be implemented in dental practice, in combination with or without a change in factor-replacement therapy. Clinical guidelines for the use of tranexamic acid can only be provided after dividing dental procedures into low-risk and high-risk proce.
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