Abstract
Background:Photodynamic therapy (PDT) is a method of microbial reduction which can benefit periodontal treatment in areas of difficult access, such as deep pockets and furcations. The aim of this randomized controlled clinical trial was to evaluate the effects of PDT as an adjunct to full-mouth ultrasonic debridement in the treatment of severe chronic periodontitis. Material and Methods:Twenty-two patients with at least one pocket with a probing depth (PD) of ≥7 mm and one pocket with a PD of ≥5 mm and bleeding on probing (BOP) on each side of the mouth were included, characterizing a split mouth design. The control group underwent full-mouth ultrasonic debridement and the test group received the same treatment associated with PDT. The PDT was performed on only one side of the mouth and the initial step consisted of subgingival irrigation with 0.005% methylene blue dye. Two minutes after applying the photosensitizer, the low power laser - AsGaAl (Photon Lase III - PL7336, DMC, São Carlos -São Paulo, Brazil) was applied (660 nm, 100 mW, 9 J, 90 seconds per site, 320 J/cm2, diameter tip 600 µm).The following clinical parameters were evaluated: plaque index, gingival index, BOP, gingival recession (GR), PD, and clinical attachment level (CAL). All parameters were collected before, 1, 3 and 6 months after treatment.Results:An improvement in BOP, PD and CAL was observed after treatment, in both groups, but without any difference between them. After 6 months, the PD decreased from 5.11±0.56 mm to 2.83±0.47 mm in the test group (p<0.05) and from 5.15±0.46 mm to 2.83±0.40 mm in the control group (p<0.05). The CAL changed, after 6 months, from 5.49±0.76 mm to 3.41±0.84 mm in the test group (p<0.05) and from 5.53±0.54 to 3.39±0.51 mm in the control group (p<0.05).Conclusion:Both approaches resulted in significant clinical improvements in the treatment of severe chronic periodontits, however, the PDT did not provide any additional benefit to those obtained with full-mouth ultrasonic debridement used alone.
Highlights
In the last years, the full-mouth ultrasonic debridement raised as a new non-surgical treatment based on the knowledge that removing the toothJ Appl Oral Sci. 208 2013;21(2):208-14structure is not a prerequisite for periodontal healing, because bacterial lipopolysaccharide is removed from the root surface12,20
Despite the existent biological plausibility in Photodynamic therapy (PDT), the results of the present study showed that PDT does not provide additional clinical EHQH¿W WR QRQVXUJLFDO SHULRGRQWDO WKHUDS\
The results revealed improvements in BOP, probing depth (PD) and clinical attachment level (CAL) after both treatments, but there was no difference between the groups in any of the clinical parameters assessed
Summary
The full-mouth ultrasonic debridement raised as a new non-surgical treatment based on the knowledge that removing the toothJ Appl Oral Sci. 208 2013;21(2):208-14structure is not a prerequisite for periodontal healing, because bacterial lipopolysaccharide is removed from the root surface. WKH SHULRGRQWDO GHEULGHPHQW GH¿QHG E\ 6PDUW HW al. (1990) as a conservative instrumentation regimen of overlapping strokes and light pressure used for only a limited time period, is considered an alternative for the treatment of chronic periodontitis10,29 The purpose of this approach is to produce a biologically compatible root surface for healthy attachment. Photodynamic therapy (PDT) is a method of microbial reduction which can EHQH¿W SHULRGRQWDO WUHDWPHQW LQ DUHDV RI GLI¿FXOW DFFHVV VXFK DV GHHS SRFNHWV DQG furcations. The aim of this randomized controlled clinical trial was to evaluate the effects of PDT as an adjunct to full-mouth ultrasonic debridement in the treatment of severe chronic periodontitis. Conclusion: Both approaches resulted in VLJQL¿FDQW FOLQLFDO LPSURYHPHQWV LQ WKH WUHDWPHQW RI VHYHUH FKURQLF SHULRGRQWLWV KRZHYHU WKH 3'7 GLG QRW SURYLGH DQ\ DGGLWLRQDO EHQH¿W WR WKRVH REWDLQHG ZLWK IXOOPRXWK XOWUDVRQLF debridement used alone
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