Association of active oxygen-releasing gel and photodynamic therapy in the treatment of residual periodontal pockets in type 2 diabetic patients: A randomized controlled clinical study.

Abstract

The aim of this study was to evaluate the effect of active oxygen-releasing gel as an adjuvant, with and without antimicrobial photodynamic therapy (aPDT), in the treatment of residual pockets in periodontal patients with type 2 diabetes mellitus (DM2). Patients with residual pockets with probing depth (PD) ≥4mm and bleeding on probing (BOP) were divided into the following groups: SI (n = 17)-subgingival instrumentation in a single session; BM (n=17)-SI followed by local application of active oxygen-releasing gel inside the periodontal pocket for 3min; BM+aPDT (n=17)-SI followed by application of BM for 3min and pocket irrigation with methylene blue, and 660-nm diode laser irradiation at 100mW for 50s. The periodontal clinical parameters, serum levels of glycated hemoglobin, and immunological analysis of crevicular fluid were evaluated. All data were submitted to statistical analysis (α=5%). A significant reduction in BOP was verified at 90 and 180days in the BM+aPDT group. The percentage of sites with PD≥4mm was significantly reduced at 90days in BM+aPDT and BM, whereas after 180days only BM showed a significant reduction. In the BM+aPDT group, there was a significant reduction in tumor necrosis factor α levels at 90days. There were no differences between the treatments. The use of adjuvant active oxygen-releasing gel, with or without aPDT, resulted in the same clinical benefits as SI in the treatment of residual pockets in poorly controlled DM2 patients.