Control of gingival hemorrhage in hemophilic patients by inhibition of fibrinolysis with tranexamic acid

The aim of the present investigation was to evaluate the effect of mouthrinsing with tranexamic acid on the demand for replacement therapy in hemophilic patients demonstrating spontaneous gingival bleeding or bleeding following subgingival scaling. The study included one retrospectively studied group (I) of hemophilic patients treated with oral antifibrinolytics, replacement therapy and local hemostatics, and a prospectively studied group (II) in whom no replacement therapy but systemic and/or local antifibrinolytic treatment with tranexamic acid was employed. Six of the patients in group T received replacement therapy to control bleeding, while none of the patients in group II experienced bleeding episodes demanding replacement therapy. The difference in the frequency of demand for replacement therapy between the two groups was statistically significant (p<0.02). Based on the present findings, it is advocated that treatment of gingival bleeding in hemophilic patients should include local antifibrinolytic treatment.