Efficacy of a Biodegradable Dressing Containing Tranexamic Acid for Prevention of Alveolar Osteitis: A Randomized Clinical Trial.

Abstract

Aim: This study aimed to evaluate the efficacy of a biodegradable dressing containing tranexamic acid in preventing alveolar osteitis (AO) following mandibular third molar extraction and to investigate the impact of various risk factors on its occurrence, including smoking, the use of oral contraceptives, a history of pericoronitis, and the difficulty level of the procedure.

Materials and methods: This double-blind, randomized, controlled clinical trial was conducted on 182 patients requiring mandibular third molar extraction. The patients were randomly assigned to two groups and standardized in terms of gender, age, level of difficulty of surgery, smoking status, and intake of oral contraceptives. After the surgical extraction of the third molars, the control group received a biodegradable dressing without any loaded medication. The experimental group received a biodegradable dressing loaded with tranexamic acid in the extraction socket. The patients were recalled after 3 and 7 days, and the presence/absence of blood clots, detritus, empty sockets, halitosis, and pain using a visual analog scale (VAS) was assessed. Data were analyzed using the Chi-squared test, independent t-test, exact logistic regression, and repeated measures ANOVA (α = 0.05).

Results: The incidence of AO was not significantly different between the two groups (7.6% in the experimental group and 8.9% in the control group, p = 0.744). The odds of AO development in patients with level II or III difficulty were 9.169 times the odds of AO in patients with level I difficulty (p = 0.015). The experimental group had significantly lower pain than the control group (p < 0.001). The interaction effect of time and AO was significant on pain (p < 0.001).

Conclusion: A biodegradable dressing loaded with tranexamic acid was ineffective in preventing AO after third molar extraction but significantly decreased postoperative pain.

Clinical significance: There is a critical need to explore effective strategies for reducing postoperative complications such as pain and AO following mandibular third molar extractions. The findings of this study highlight the potential clinical application of biodegradable dressings containing tranexamic acid for pain management, offering a translational benefit in improving patient comfort and recovery experiences. How to cite this article: Sohrabi A, Bayat F, Amirfarhangi S, et al. Efficacy of a Biodegradable Dressing Containing Tranexamic Acid for Prevention of Alveolar Osteitis: A Randomized Clinical Trial. J Contemp Dent Pract 2024;25(11):1015-1021.