Photodynamic therapy as an adjunct to non-surgical periodontal treatment: a randomized, controlled clinical trial.
BACKGROUND
Recent preclinical and clinical data have suggested a potential benefit of photodynamic therapy (PDT) in the treatment of periodontitis. However, there are very limited data from controlled clinical trials evaluating the effect of PDT in the treatment of periodontitis. The aim of this study was to evaluate the clinical and microbiologic effects of the adjunctive use of PDT to non-surgical periodontal treatment.


METHODS
Twenty-four subjects with chronic periodontitis were randomly treated with scaling and root planing followed by a single episode of PDT (test) or scaling and root planing alone (control). Full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing depth (PD), gingival recession, and clinical attachment level (CAL) were measured at baseline and 3 and 6 months after therapy. Primary outcome variables were changes in PD and CAL. Microbiologic evaluation of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia (previously T. forsythensis), Treponema denticola, Parvimonas micra (previously Peptostreptococcus micros or Micromonas micros), Fusobacterium nucleatum, Campylobacter rectus, Eubacterium nodatum, Eikenella corrodens, and Capnocytophaga spp. was performed at baseline and 3 and 6 months following therapy by using a commercially available polymerase chain reaction test.


RESULTS
At 3 and 6 months after treatment, there were no statistically significant differences between the groups with regard to CAL, PD, FMPS, or microbiologic changes. At 3 and 6 months, a statistically significantly greater improvement in FMBS was found in the test group.


CONCLUSIONS
The additional application of a single episode of PDT to scaling and root planing failed to result in an additional improvement in terms of PD reduction and CAL gain, but it resulted in a significantly higher reduction in bleeding scores compared to scaling and root planing alone.
Christodoulides
Nicos
N
Department of Periodontology, Radboud University Medical Center, Philips van Leydenlaan 25, Nijmegen, The Netherlands.
Nikolidakis
Dimitris
D
Chondros
Panagiotis
P
Becker
Jürgen
J
Schwarz
Frank
F
Rössler
Ralf
R
Sculean
Anton
A
D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000187:drug effects; D001439:Bacteroides / Q000187:drug effects; D044883:Campylobacter rectus / Q000187:drug effects; D002206:Capnocytophaga / Q000187:drug effects; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003774:Dental Plaque Index; D012534:Dental Scaling; D016124:Eikenella corrodens / Q000187:drug effects; D005051:Eubacterium / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D016967:Fusobacterium nucleatum / Q000187:drug effects; D005884:Gingival Hemorrhage / Q000188:drug therapy; D005889:Gingival Recession / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010462:Peptostreptococcus / Q000187:drug effects; D017622:Periodontal Attachment Loss / Q000188:drug therapy; D010514:Periodontal Pocket / Q000188:drug therapy; D010518:Periodontitis / Q000188:drug therapy* / Q000382:microbiology; D010778:Photochemotherapy / Q000379:methods*; D016966:Porphyromonas gingivalis / Q000187:drug effects; D018713:Prevotella intermedia / Q000187:drug effects; D016745:Root Planing; D048373:Treponema denticola / Q000187:drug effects