Effective control of pain, edema, trismus, and fluid loss is critical for optimal postoperative recovery following third molar extractions. This study aimed to evaluate the effects of tranexamic acid on inflammatory and biophysical parameters after such procedures. A randomized clinical trial with a split-mouth design was conducted, in which patients underwent bilateral lower third molar extractions on separate hemifaces, with a minimum interval of 15 days. One side received oral tranexamic acid (1.5 g/day for 3 days, starting 8 hours prior to surgery), while the other side received a placebo, ensuring blinding. Postoperative assessments included pain (Visual Analogue Scale), edema (tragus to labial commissure distance), trismus (interincisal distance), and body composition via bioimpedance at immediate, 2-, 4-, and 7-day intervals. Results demonstrated a significant reduction in pain, edema, and trismus on postoperative days 2 and 4 in the tranexamic acid group. Additionally, a smaller variation in body composition was observed, suggesting reduced fluid loss. It is concluded that tranexamic acid offers meaningful benefits in postoperative recovery, representing a promising strategy for the surgical management of third molars.
