ALTERATION OF HEMOSTASIS IN PATIENTS TREATED WITH SUBGINGIVAL NSAIDS DURING PERIODONTAL THERAPY

The use of topical NSAIDs to complement periodontal therapy could help resolve the inflammatory process and clinical signs of the disease more rapidly. A randomized clinical trial was performed on 59 patients, of whom 33 had chronic periodontitis and 26 were healthy controls. All diseased patients underwent scaling and root planing in one quadrant per week with subgingival application of gel 48 hours after each session. Gel was applied to healthy patients with the same frequency. Four types of gel were used, containing respectively placebo, acetylsalicylic acid (ASA) 1%, Ketoprofene (KTP) 1% and Ketoprofene 2%. The following clinical variables were studied: probing depth, attachment level, dental mobility, plaque index, gingival index and bleeding on probing; as well as the biochemical variables: bleeding time (Ivy), platelet count in whole blood and platelet-rich plasma, and platelet aggregation induced by different agonists. Regarding clinical results, ASA was the most effective in reducing probing depth, gingival index and bleeding on probing (p<0.05). KTP 1% and 2% behaved similarly to each other and less effectively than ASA but differed significantly from placebo (p<0.05). Regarding biochemical tests, ASA had a highly significant inhibitory effect on platelet aggregation for all the agonists used. KTP 2% produced similar, though weaker responses. KTP 1% only showed alteration in the first aggregation phase at maximum ADP concentration of and none at the minimum concentration (p<0.05).