Study of the effect of tranexamic acid in controlling periapical bleeding during root canal therapy and the performance of biological materials
Ghader Feizi, Leila Sarami, Soha Feizi, Hamid Razavian, Abbasali Khademi, Zahra AtaieABSTRACT
Background:
Periapical bleeding is a significant complication that can hinder the completion of root canal treatment. This study aimed to evaluate the effectiveness of tranexamic acid in controlling periapical bleeding during root canal procedures.
Materials and Methods:
In a randomized, blinded clinical trial, 40 patients requiring root canal treatment were randomly assigned to intervention (tranexamic acid) or control (normal saline) groups using a computer-generated sequence with allocation concealment. After access cavity preparation and canal shaping with ProTaper Next rotary files to size X2 under 2.5% sodium hypochlorite irrigation, if bleeding persisted beyond 10 min, the intervention group received 1 cc of tranexamic acid injected via a 27-G regular insulin syringe, while the control group received 1 cc of normal saline. Bleeding cessation was assessed by inserting a sterile paper point to the working length at 3, 6, and 10 min; cessation was defined as no visible blood staining on the paper point. The outcome assessor was blinded to group allocation. Data were analyzed using the Mann–Whitney
Results:
The mean bleeding cessation time was 1.75 ± 0.063 min in the tranexamic acid group compared to 3.35 ± 0.93 min in the saline group. The Mann–Whitney test revealed a statistically significant difference (
Conclusion:
Tranexamic acid effectively controls periapical bleeding within 10 min during root canal therapy, allowing continuation of the procedure in the same session. Further studies are needed to evaluate its safety profile and impact on long-term treatment outcomes.