Adjunctive use of antimicrobial photodynamic therapy in periodontal treatment of a patient susceptible to osteoradionecrosis

Abstract

Photodynamic therapy (PDT) has emerged as an adjunct to conventional periodontal therapy since its antimicrobial effect has been discovered. The oral health of patients with head and neck cancer undergoing radiotherapy or those who have completed such treatment deteriorates as oral tissues, including the periodontium, are adversely affected. Vascular changes, in particular, predispose the periodontium for degeneration and also reduce the potential of tissues to regenerate following periodontal surgery. Since periodontal surgical procedures or extraction of teeth carries the risk of osteoradionecrosis (ORN) in such cases, a conservative approach with nonsurgical measures is preferred for the treatment of periodontal diseases. This report highlights a case of treatment of localized chronic periodontitis around endodontically treated teeth in a patient with history of radiotherapy for the treatment of oral cancer. In addition to mechanical debridement, PDT was used to disinfect the moderately deep periodontal pockets, resulting in significant improvement. No complication was observed after therapy and good periodontal health has been maintained for the last 18 months.