Adjunctive Treatment of Chronic Periodontitis With Systemic Low‐Dose Aspirin Therapy

Focused Clinical Question In patients presenting with generalized moderate‐to‐severe chronic periodontitis (CP), does adjunctive use of systemic low‐dose aspirin therapy with non‐surgical periodontal therapy improve the maintenance of alveolar bone support and/or clinical attachment level? Clinical Scenario A 55‐year‐old male presents for a periodontal evaluation after deep pockets were noted at a periodontal maintenance visit. The patient reports a dental history significant for non‐surgical periodontal therapy and resective osseous surgery ≈18 years before the current evaluation, and has been seeing a general dentist for periodontal maintenance every 6 months since his surgical treatment. The patient also reports a medical history significant for hypertension and a recent transient ischemic attack (TIA). After the TIA, the patient was placed on 325 mg acetylsalicylic acid daily to reduce his risk of cardiovascular and cerebrovascular events. The treatment plan includes non‐surgical periodontal therapy followed by resective and regenerative surgeries. During medical consultation, the patient's physician states a preference that the patient continue taking aspirin therapy throughout periodontal treatment. The patient is concerned about disease progression after the previous surgical therapy and inquires about the advantages and disadvantages of low‐dose aspirin therapy use in patients with CP. See Figures 1 through 3 for the intraoral presentation of the patient.