Premium
Photodynamic Therapy During Supportive Periodontal Care: Clinical, Microbiologic, Immunoinflammatory, and Patient‐Centered Performance in a Split‐Mouth Randomized Clinical Trial
Author(s) -
Kolbe Maria F.,
Ribeiro Fernanda V.,
Luchesi Vanessa H.,
Casarin Renato C.,
Sallum Enilson A.,
Nociti Francisco H.,
Ambrosano Gláucia M.B.,
Cirano Fabiano R.,
Pimentel Suzana P.,
Casati Marcio Z.
Publication year - 2014
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.2014.130559
Subject(s) - medicine , bleeding on probing , scaling and root planing , randomized controlled trial , aggregatibacter actinomycetemcomitans , periodontitis , chronic periodontitis , photodynamic therapy , porphyromonas gingivalis , gastroenterology , chemistry , organic chemistry
Background: This study investigates the effect of photodynamic therapy (PDT) as monotherapy during supportive periodontal therapy. Methods: A split‐mouth, randomized controlled trial was conducted in patients with chronic periodontitis (N = 22) presenting at least three residual pockets (probing depth [PD] ≥5 mm with bleeding on probing [BOP]). The selected sites randomly received the following: 1) PDT; 2) photosensitizer (PS); or 3) scaling and root planing (SRP). At baseline and 3 and 6 months, clinical, microbiologic (real‐time polymerase chain reaction analyses), cytokine pattern (multiplexed bead immunoassay), and patient‐centered (regarding morbidity) evaluations were performed. Results: All therapies promoted similar improvements in clinical parameters throughout the study ( P <0.05), except that BOP was not reduced in the PS protocol ( P >0.05). Lower levels of Aggregatibacter actinomycetemcomitans were observed in the PDT and SRP protocols at 3 months when compared with the PS protocol ( P <0.05). An inferior frequency detection of Porphyromonas gingivalis was observed in the PDT protocol at 3 and 6 months and in the SRP protocol at 6 months from baseline ( P <0.05). In addition, PDT protocol presented inferior frequency of P. gingivalis at 3 months when compared with the other therapies ( P <0.05). Only patients in the PDT protocol exhibited augmented levels of anti‐inflammatory interleukin (IL)‐4 and reduced proinflammatory IL‐1β and IL‐6 throughout the study ( P <0.05). Intergroup analyses showed reduced IL‐10 and increased interferon‐γ and IL‐1β levels in the PS protocol when compared with the other therapies during follow‐ups ( P <0.05). No differences in morbidity were observed between the therapies ( P >0.05), although the need for anesthesia was higher in SRP‐treated sites ( P <0.05). Conclusion: PDT as an exclusive therapy may be considered a non‐invasive alternative for treating residual pockets, offering advantages in the modulation of cytokines.