Clinical and microbiological effects of adjunctive photodynamic diode laser therapy in the treatment of chronic periodontitis: A randomized clinical trial.

Sahana Mallineni,Mahaboob V Shaik,Sreenivas Nagarakanti,Ramesh Reddy Bv,Vijay K Chava,Sumanth Gunupati

doi:10.34172/joddd.2020.030

Abstract

Background. Conventional mechanical debridement alone cannot eliminate bacteria and their products from periodontal pockets. Adjunctive therapies improve tissue healing through detoxification and bactericidal effects. Photodynamic therapy (PDT) is a non-invasive treatment procedure that involves the use of a dye as a photosensitizer to attach to the target cell and be activated by a photon of an appropriate wavelength. This study aimed to assess the effectiveness of PDT in treating periodontitis as an adjunct to scaling and root planing. Methods. Fifteen subjects with chronic periodontitis were treated randomly with scaling and root planing (SRP), followed by a single PDT (test) or SRP (control) episode alone. Full-mouth plaque index (PI), sulcus bleeding index (SBI), probing depth (PD), and clinical attachment level (CAL) were assessed at baseline and 1-month and 3-month intervals. Microbiological evaluation of Porphyromonas gingivalis (Pg) in subgingival plaque samples was performed using a commercially available real-time polymerase chain reaction. Results. The results revealed a significant difference in PI, SBI, PD, CAL, and microbiological parameters between the groups one and three months after treatment. Conclusion. A combination of PDT and SRP gave rise to a significant improvement in clinical and microbiological parameters in patients with chronic periodontitis.

Highlights

Periodontitis is considered the most common oral disease in response to the chronic infection caused by different periodontopathogenic bacteria, resulting from inflammation of structures supporting teeth.[1]It has been shown that conventional scaling and root planing (SRP) result in significant clinical improvements, but they do not completely remove periodontopathogens, especially in deep periodontal pockets[2,3] and cannot prevent bacterial invasion into periodontal soft tissues.[4]
A split-mouth randomized clinical trial was performed to determine the effectiveness of Photodynamic therapy (PDT) in treating chronic periodontitis as an adjunct to SRP
The present study showed that, in line with previous research, the clinical and microbiological outcomes of non-surgical periodontal care (SRP) of chronic periodontitis improved by the adjunctive use of PDT.[19,20]

Summary

Introduction

It has been shown that conventional scaling and root planing (SRP) result in significant clinical improvements, but they do not completely remove periodontopathogens, especially in deep periodontal pockets[2,3] and cannot prevent bacterial invasion into periodontal soft tissues.[4]. SRP might even favor bacteremic and endotoxemic events.[5,6] Another crucial issue in the treatment of periodontitis is that periodontopathogenic bacteria can penetrate and persist in epithelial cells of the periodontal pockets and superficial gingiva,[7,8] evading host immunity and conventional antimicrobial drugs. This might predispose to the recolonization of periodontal tissues after treatment and disease relapse.[9]. Resistance development might be the consequence of the excessive use of antibiotics in general bacterial or viral infections

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