Novel Use of Tranexamic Acid to Reduce Time Taken During Bracket Placement for Orthodontic Traction of Impacted Teeth: An Observational Study.

Abstract

Background and aim: Therapeutic surgical exposure and placing a bracket on the impacted tooth is an approach which involves both maxillofacial surgeon and an orthodontist. The prime requirement is complete hemostasis and isolation which sometimes is difficult to achieve. This study was conducted to evaluate the efficacy of topical application of Tranexamic acid (TA) intra-operatively to facilitate this Procedure. Time, duration from exposure of the crown of the impacted tooth to bonding of brackets, allergic reactions, intra-operative blood loss, surgeon's perception and patient's comfort were the criteria's which were evaluated.

Method: This prospective observational study had two groups, for which 10 patients selected with impacted teeth. In first group topical application of TA soaked gauze pieces were used, and in second group normal saline soaked gauze pieces were used as control.

Results: Statistically significant results were achieved for experimental group in terms of Intra operative time duration and intra operative blood loss which inferenced that better isolation was achieved with the local use of Tranexamic acid, Surgeon's perception was good which inferenced that Surgeon was more comfortable in experimental group, Also Patients were more comfortable and postoperative wound healing was better in experimental group and no adverse reactions were reported in any group.

Conclusion: Topical use of tranexamic acid achieved better results for therapeutic surgical exposure showing good isolation for bonding the brackets. This technique is very cost effective, easy to apply with no adverse effects. With additional use of hemostatic agent topically; reduction in time duration, less bond failure, uneventful healing and improved patient's and surgeon's satisfaction is achieved.