Do We Really Know How to Manage Anticoagulated Patients for Periodontal Nonsurgical Therapy? An Observational Cohort Study

OBJECTIVES: The aim of this work is to assess and compare the impact of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKA) during and immediately after periodontal nonsurgical therapy. MATERIALS AND METHODS: A prospective observational cohort study was conducted with patients who presented a history of cardiovascular disease and were treated with either DOACs or VKAs in order to evaluate the differences in bleeding events between these groups. Supra-gingival versus supra- and sub-gingival scaling was performed in the enrolled subjects according to periodontal indications. Bleeding scores were recorded in the intra- and post-operative phases. After testing the normality of the data, non-parametric methods were used to compare bleeding scores between groups at each timepoint. A p-value of < 0.05 and 95% confidence intervals were used to determine statistical significance. RESULTS: Overall, 120 patients were included in this study (61 in the VKA group and 59 in the DOAC group). The mean age was 75.12 ± 7.84 years, and the composition of the patients was equal in terms of gender. There were no statistically significant differences between the DOAC and VKA groups, both in terms of the use of supra-gingival versus supra- and sub-gingival scaling and bleeding in the intra- and post-operative phases. CONCLUSION: Patients undergoing periodontal non-surgical therapy have the same bleeding risk regardless of the pharmacological therapy, and these bleeding events can be considered limited and of low grade.