Antimicrobial photodynamic therapy vs. local minocycline in addition to non-surgical therapy of deep periodontal pockets: a controlled randomized clinical trial.

Abstract

To investigate the additional influence of either antimicrobial photodynamic therapy (aPDT; Helbo® Photodynamic Systems) or local application of minocycline microspheres (MC; Arestin, OraPharma) on clinical and microbiological healing results in deep periodontal pockets (PPD ≥6mm) following non-surgical periodontal therapy (SRP). Forty-five patients with chronic periodontitis were evaluated: test group aPDT + SRP (n=15), positive control group MC + SRP (n=15), and negative control group SRP-alone (n=15). Clinical and microbiological healing parameters were recorded in every patient for four experimental teeth at baseline, 6weeks, and 3, 6, and 12months. Wilcoxon signed-rank test and Mann-Whitney U test were used for statistical analysis (α=0.05). Significant improvements in clinical and microbiological parameters were found for all groups after 6weeks and 3, 6, and 12months. Differences between groups were not statistically significant. Changes after 12months [median (25/75%)] are as follows: reduction in PPD [mm]: aPDT + SRP 2 (1/3), MC + SRP 3 (1/4), SRP-alone 2 (1/3); percentage of residual BOP positive teeth [%]: aPDT + SRP 75 (25/100), MC + SRP 33.3 (0/50), SRP-alone 66.7 (25/75). Within the limitations of this study, neither the applied aPDT system nor MC showed a significant additional influence on clinical and microbiological healing outcomes in deep periodontal pockets compared to SRP alone. In deep periodontal defects, the efficacy of non-surgical periodontal treatment seems not to be improved by adjunctive use of antimicrobial photodynamic therapy or minocycline microspheres.