Abstract
The effectiveness of adjunctive photodynamic treatment (PDT) to non-surgical periodontal therapy has been shown to depend on initial periodontal status. As molar furcation involvement impairs healing response to non-surgical periodontal therapy, the aim of this study was to evaluate the impact of furcation involvement on PDT outcomes. Thirty-six patients suffering from severe chronic periodontitis were included in a 6-month split-mouth randomized clinical trial. PDT applications used the toluidine blue O and a light-emitting diode (LED) with a red spectrum. Repeated PDT applications were performed in addition to non-surgical periodontal treatment at baseline and at 3-months. Pocket probing depth (PPD), plaque index, bleeding on probing, and clinical attachment level were recorded at baseline, and again at 3- and 6-months. Furcation sites of molars were compared to other sites of molars and non-molars. Multilevel analysis showed no PDT effect in molar furcation sites while an additional significant reduction (odds ratio = 0.67) of pockets with PPD > 5 mm in other sites at 3-months was measured. PPD reduction appeared delayed in molar furcation sites treated with PDT. There is no additional apparent benefit to use PDT in molar furcation sites for the reduction of pockets with PPD > 5 mm contrary to other sites.
Highlights
Periodontal diseases are infectious diseases and periodontal therapies aim to eliminate supraand subgingival infections [1]
Thirty-six patients were initially included in the study corresponding to 2814 analyzed sites in the test group and 2802 analyzed sites in the control group
This study showed that photodynamic treatment (PDT) efficiency was significantly and negatively influenced by the presence of molar furcation involvement
Summary
Periodontal diseases are infectious diseases and periodontal therapies aim to eliminate supraand subgingival infections [1]. SRP has some limitations, mainly in molars [2], essentially due to their complex anatomy [3]. In these multi-rooted teeth, furcation involvement has been shown to impair SRP response, limiting the reduction of PPD and clinical attachment loss (CAL), as well as increasing the risk of disease recurrence [4,5] and the persistence of PPD > 5 mm [6]. The complex morphology of furcation sites renders difficult the debridement of periodontal lesions and limits the removal of periodontal pathogens [3,7]. Long-term studies have shown that molar tooth loss is mainly and negatively
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