Management of Periodontal Disease with Adjunctive Therapy with Ozone and Photobiomodulation (PBM): A Randomized Clinical Trial

Andrea Scribante,Simone Gallo,Luca Politi,Anand Marya,Andrea Butera,Riccardo Soleo,Fabio Di Fonso,Adith Venugopal,Maurizio Pascadopoli

doi:10.3390/photonics9030138

Andrea Scribante, Simone Gallo + Show 7 more

Open Access

https://doi.org/10.3390/photonics9030138

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Abstract

Periodontitis is an inflammatory condition of the soft and hard tooth-supporting tissues, representing the first cause of tooth loss. In addition to standard mechanical debridement (Scaling and Root Planing, SRP), further approaches have been proposed as adjuncts. The aim of the present randomized clinical trial is to compare the efficacy of ozone or photobiomodulation (PBM) therapy in addition to SRP to treat periodontal disease. According to a split-mouth design, 240 pathological sites, corresponding to 30 periodontal patients, were randomly divided according to the professional oral hygiene protocol performed at baseline (T0) and after 1 (T1), 2 (T2), 3 (T3), 4 (T4), 5 (T5), and 6 (T6) months. A total of 120 sites underwent an ozonized water administration (ozone group), whereas the other 120 sites were treated with photobiomodulation (PBM group), both in addition to SRP. At every timepoint, the following clinical indexes were assessed: Probing Pocket Depth (PPD) (measured on six sites per element), Plaque Index (PI), and Bleeding on Probing (BOP). As regards PPD, significant intergroup differences were noticed from T5, with significantly lower values in the PBM group (p < 0.05), where values further decreased at T6 (p < 0.05). Both PI and BoP generally decreased from baseline to T6 in both groups; a significant difference was found between T0 and T1 among the groups (p < 0.05), with a progressively higher reduction in the PBM group among the time frames of the study, despite intergroup comparisons not being significant (p > 0.05). Both ozone and PBM appear to be effective adjuvant treatments to SRP, obtaining a slightly better outcome for the latter in the long term, with significant differences at T5 and T6 for PPD. However, because of the absence of standardized protocols for PBM considering both therapeutic and research purposes, no definitive conclusions can be reached, and further studies are required.

Highlights

Periodontal disease is an inflammatory condition of soft and hard tooth-supporting tissues, representing the first cause of tooth loss [1] and the sixth most prevalent condition worldwide [2]
Probing Pocket Depth (PPD) was calculated in millimeters; Bleeding on Probing (BOP) and Plaque Index (PI) were calculated in percentages
For BOP and PI, we used the Kruskal–Wallis test followed by the Mann–Whitney U test

Summary

Introduction

Periodontal disease is an inflammatory condition of soft and hard tooth-supporting tissues, representing the first cause of tooth loss [1] and the sixth most prevalent condition worldwide [2]. It derives from an untreated gingival inflammation caused by bacterial plaque accumulation. It occurs as a bleeding of the marginal gum, with an irreversible periodontal attachment loss, rise of pockets and recessions, bone loss, tooth mobility, and exfoliation [3]. Scaling and Root Planing (SRP) is the gold standard non-surgical therapy, which aims to remove dental plaque and calculus (scaling) as well as to smooth the root surfaces (root planing) [9]. Adjunctive therapeutic approaches have been proposed, such as the use of antibiotics [11], probiotics [12], ozone application [13], and the photodynamic therapy [14]

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