Literature DB >> 24555751

Photodynamic therapy during supportive periodontal care: clinical, microbiologic, immunoinflammatory, and patient-centered performance in a split-mouth randomized clinical trial.

Maria F Kolbe1, Fernanda V Ribeiro, Vanessa H Luchesi, Renato C Casarin, Enilson A Sallum, Francisco H Nociti, Gláucia M B Ambrosano, Fabiano R Cirano, Suzana P Pimentel, Marcio Z Casati.   

Abstract

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.

Entities:  

Keywords:  Chronic periodontitis; cytokines; microbiology; pain; periodontal pocket; photochemotherapy

Mesh:

Substances:

Year:  2014        PMID: 24555751     DOI: 10.1902/jop.2014.130559

Source DB:  PubMed          Journal:  J Periodontol        ISSN: 0022-3492            Impact factor:   6.993


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