The Efficacy of Tranexamic Acid in the Reduction of Incidence of Dry Socket: An Institutional Double Blind Study

Background: Alveolar osteitis (AO) is an important postoperative problem with an incidence of 20% to 35% especially prevalent after the removal of mandibular molars. Fibrinolysis with subsequent loss of blood clotting is believed to be the general cause of AO. Objectives: This study aims to evaluate the efficacy of tranexamic acid, an antifibrinolytic agent in comparison with a placebo with respect to the reduction of incidence of AO after the extraction of mandibular molars by using following parameters: Pain, disintegration of Clot, halitosis. Materials and Methods: A double blind study consisted of 60 patients, who underwent routine dental extractions of mandibular molar teeth. Group A (30 patients) requiring routine dental extractions of mandibular teeth was randomly selected and was administered a dose of tranexamic acid orally (Pause 500mg) one hour prior to extraction of teeth. Gel foam soaked in tranexamic acid (160mg) was placed into the extraction socket postoperatively. A figure of eight silk suture was placed over the socket to secure the gelfoam. Group B (30 patients); a placebo (crocin) was given orally one hour prior to the extraction and gel foam soaked in saline was placed into the extraction socket postoperatively. A figure of eight silk suture was placed over the socket. Pain was rated individually by each patient at 3rd, 7th, 14th day after extraction and the results was statistically analysed. Results: This study supports that the use of tranexamic acid both locally and systemically following the removal of the teeth reduces the incidence of AO associated with the extraction of mandibular molars. Conclusion: Tranexamic acid has several advantages also when used for simple dental extractions, namely: low cost and ready availability and therefore we recommend this treatment modality.