Tranexamic acid in alveolar sockets in the prevention of alveolitis sicca dolorosa

Abstract

The effect of trans-4-amino-methyl-cyclohexane acid (AMCA) and a placebo preparation on the development of alveolitis sicca dolorosa (ASD) was investigated in a double-blind designed experiment. The preoperative registrations were age, sex, use of oral contraceptives, menstrual cycle, smoking, degree of impaction and operation time. The study included 120 healthy persons. Each person had bilateral impacted mandibular molars removed surgically at one session. AMCA (160 mg/extraction site) or placebor was applied in each socket after the operation. The postoperative course was evaluated on average 5 days later by the use of 13 different variables describing local and general discomfort. The incidence of ASD was 7.5% in the AMCA side and 5.0% in the placebo side. The result shows that a local inhibition of plasminogen activation by AMCA is insufficient to prevent the development of ASD. The occurrence of ASD and postoperative discomfort was not increased in women operated during the menstrual period. The usage of oral contraceptives is known to be associated with a high frequency of ASD. Women taking oral contraceptives may therefore postpone the operation to the withdrawal period of the pill, to reduce the risk of developing ASD. Postoperative pains and the consumption of analgetics were significantly increased in patients who were habitual smokers.

PIP: This double-blind study designed to assess the effect of trans-r-amino-methyl-cyclohexane acid (AMCA) vs. placebo on development of alveolitis sicca dolorosa (ASD) had as preoperative registration requirements age, sex, use of oral contraceptives, menstrual cycle, smoking, and degree of impaction at time of operation. Following operation for impacted molars, AMCA or placebo was applied, and 5 days later the postoperative course was evaluated. Overall, AMCA did not have enough local inhibition of plasminogen activation to prevent development of ASD, since incidence of ASD was 7.5% in the treated side and 5% in the placebo side. Menstrual period did not augment postoperative discomfort. Oral contraceptive use, however, gave a much higher risk of developing ASD, and it is recommended that women withdraw from oral contraception before oral surgery. Smoking increased postoperative pain.