Clinical, microbiological and immunological outcomes with photodynamic therapy as an adjunct to full-mouth scaling in patients undergoing fixed orthodontic treatment.

Abstract

The purpose of this clinical study was to evaluate the adjunctive role of photodynamic therapy (PDT) in the improvement of clinical, microbiological and immunological parameters among adolescent patients undergoing fixed orthodontic treatment (FOT) during the period of 6 weeks. Fifty adolescent patients undergoing FOT were divided into following two groups; Group-A: PDT as an adjunct to full-mouth scaling (FMS) and, Group-B: FMS alone. Full-mouth plaque scores (PS), bleeding on probing (BOP) and probing depth (PD) were estimated using full-mouth six point periodontal charting. Plaque samples were collected for percentage bacterial counts of P. intermedia and P. gingivalis. Gingival crevicular fluid (GCF) sampling technique was employed for estimation of interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-α) using enzyme-linked immunosorbent assay. All measurements were performed at baseline, 3 weeks and 6 weeks. The mean age of patients in Group-A and Group-B was 15.4 years and 14.2 years, respectively. The mean duration for fixed orthodontic therapy in patients for Group A and B were 1.25 and 1.3 years, respectively. At 3 weeks follow up, both groups showed significant reduction in PS and BOP (p < 0.001). There was a statistically significant difference in BOP and PI at 6 weeks (p < 0.05). There was a statistically significant difference in IL-6 at 3 weeks and TNF-α at 6 weeks between both groups (p < 0.05). The percentage levels for both Pi and Pg significantly reduced at 3 weeks follow up in both the groups, however, these levels were again raised at 6 weeks follow up. There was a statistically significant difference between Group-A and Group-B (p < 0.05) at 3 weeks and 6 weeks follow up. Photodynamic therapy as an adjunct to FMS helps to improve clinical gingival parameters, microbial and inflammatory load. PDT showed additional benefits in reducing bleeding scores in adolescent patients undergoing FOT.