[Bleeding control of periodontal mechanical therapy for patients taking aspirin].

ABSTRACT

OBJECTIVE: To investigate the feasibility of periodontal mechanical therapy for chronic periodontitis and coronary heart disease patients with low dose of aspirin. METHODS: Sixty nine chronic periodontitis patients with coronary heart disease were randomly selected as the experimental group (medication group, group A), the control group (withdrawal group, group B) including 20 chronic periodontitis patients with coronary artery disease, stopping the drug for one week and another control group with 50 chronic periodontitis patients (group C). The three groups were examined with pocket probing, and received supragingival scaling, subgingival scaling, and root planning. Local bleeding after operation was observed. In 30 minutes after periodontal mechanical treatment, there was still a need to take some hemostatic measures (containing the oxidized cellulose putting in the periodontal pocket, gauze oppressing, and suturing). NdYAG laser was used to stop bleeding 60 minutes after operation. RESULTS: At baseline, there was no significant difference in the three groups, as to the plaque index(PLI), the probing depth (PD), and the attachment loss (AL). The bleeding index (BI)in group A was significantly higher than that in group C (P=0.024), higher than that in group B (P=0.088). The platelet maximum aggregation rate (Agg(max)) was detected in some subjects. The average Agg(max) value group A was 15.2%, which was much greater than that in group B (60.7%) and group C (62.5%). The three groups were all safe in the treatment of periodontal therapy. There were five cases of active bleeding in group A, one case in group B and one case in group C in 30 minutes after operation. In 60 minutes after operation, there was one case of bleeding actively in group A. NdYAG laser was used to stop bleeding successfully. CONCLUSION: The chronic periodontitis and coronary heart disease patients with long-term oral administration of low dose of aspirin can be safely treated with periodontal mechanical treatment, and the effect of local hemostasis is positive without stopping the drug.