Effect of periodontal basic treatment on gingival bleeding in patients with anticoagulation

ZHANG Qing; ZHAO Qian; CHEN Bao-shun; YAN Xin-ran; LIU Yong-jian

doi:10.19749/j.cn.cjgd.1672-2973.2025.02.002

Abstract：Objective To investigate the correlation between gingival bleeding and international normalized ratio(INR)of prothrombin time in patients with anticoagulant periodontitis.Methods A total of 68 periodontitis patients receiving anticoagulants or antiplatelet therapy at Taiyuan Central Hospital from January 2023 to December 2024 were enrolled and divided into two groups:an anticoagulant group(38 cases)and an antiplatelet group(30 cases).Additionally,65 periodontitis patients without anticoagulant therapy were included as controls.For the anticoagulant group,patients were further stratified into two subgroups based on pre-treatment INR values:0.8≤INR ≤ 1.2(18 cases)and 1.2＜INR ≤ 2.5(20 cases).Before periodontal basic treatment,blood samples were collected in the clinical laboratory of our hospital for blood test.INR values and blood routine of all patients were monitored,and gingival bleeding of each group was statistically analyzed 5 min,30 min,1 h,24 h,and 48 h after periodontal treatment.Results At all observation intervals(5 min,30 min,1 h,24 h,and 48 h),both the anticoagulant and antiplatelet groups exhibited significantly higher gingival bleeding rates than the control group(P＜0.01),though no significant difference was observed between the two medication groups(P＞0.05).In the anticoagulant subgroup analysis:The 0.8≤INR≤1.2 subgroup showed higher bleeding rates than controls at 5 min and 30 min(P＜0.05 and P＜0.01,respectively).The 1.2＜INR≤2.5 subgroup demonstrated elevated bleeding rates compared to both controls and the 0.8 ≤ INR ≤1.2 subgroup at 5 min,30 min,1 h,and 24 h(P＜0.05 and P＜0.01).Conclusion Periodontal basic therapy is feasible for chronic anticoagulant users with periodontitis when maintaining INR within 0.8-1.2.For patients receiving antiplatelet therapy,periodontal treatment can be safely performed without INR adjustment.