Topical tranexamic acid powder for bleeding control in dentistry: a scoping review

This scoping review evaluated the efficacy of topical tranexamic acid powder, prepared from crushed tablets, for bleeding prevention during minor oral surgical procedures.

A comprehensive literature search was conducted in accordance with PRISMA-ScR guidelines across MEDLINE/PubMed, Elsevier, Embase, BVSalud, Web of Science, and Periódicos CAPES. Studies investigating topical tranexamic acid in powder form for minor dental procedures were included. Reviews, in vitro or animal studies, and investigations focusing on systemic, injectable, or mouthwash formulations of tranexamic acid were excluded. Methodological quality was assessed using the Newcastle-Ottawa Scale and Joanna Briggs Institute critical appraisal checklists.

Ten studies met the inclusion criteria, including clinical trials, retrospective and prospective studies, case reports, and one letter to the editor. Tranexamic acid powder was applied directly to surgical sites or prepared as a paste or saline suspension, with doses ranging from 250 to 500mg. Most participants were receiving anticoagulant therapy or had underlying bleeding disorders, highlighting the need for effective local hemostatic approaches. All included studies reported successful bleeding control with topical tranexamic acid, frequently combined with additional local hemostatic measures such as sutures or gelatin sponges.

Topical tranexamic acid powder shows promise as an adjunctive measure for bleeding control in minor oral surgery, particularly in individuals at increased risk of hemorrhage. However, further studies are needed to clarify the isolated efficacy of tranexamic acid powder in dental bleeding management.Open Science Framework: https://osf.io/n5mbp.