One-year outcomes of repeated adjunctive photodynamic therapy during periodontal maintenance: a proof-of-principle randomized-controlled clinical trial.
BACKGROUND
Single photodynamic therapy (PDT) has been effective in initial periodontal therapy, but only improved bleeding on probing (BoP) in maintenance patients after a single use. Repeated PDT has not been addressed.


OBJECTIVE
To study the possible added benefits of repeated adjunctive PDT to conventional treatment of residual pockets in patients enrolled in periodontal maintenance.


METHODS
Ten maintenance patients with 70 residual pockets [probing pocket depth (PPD)>or=5 mm] were randomly assigned for treatment five times in 2 weeks (Days 0, 1, 2, 7, 14) with PDT (test) or non-activated laser (control) following debridement. The primary outcome variable was PPD, and the secondary variables were clinical attachment level (CAL) and BoP. These were assessed at 3, 6 and 12 months following the interventions.


RESULTS
Greater PPD reductions were observed in the test (-0.67 +/- 0.34; p=0.01) compared with the control patients (-0.04 +/- 0.33; NS) after 6 months. Significant CAL gain (+0.52 +/- 0.31; p=0.01) was noted for the test, but not in the control (-0.27 +/- 0.52; NS) patients after 6 months. BoP percentages decreased significantly in test (97-64%, 67%, 77%), but not control patients after 3, 6 and 12 months.


CONCLUSIONS
Repeated (five times) PDT adjunctive to debridement yielded improved clinical outcomes in residual pockets in maintenance patients. The effects were best documented after 6 months.
Lulic
Martina
M
Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong, China.
Leiggener Görög
Isabelle
I
Salvi
Giovanni E
GE
Ramseier
Christoph A
CA
Mattheos
Nikolaos
N
Lang
Niklaus P
NP
D000328:Adult; D000368:Aged; D055113:Chronic Periodontitis / Q000188:drug therapy / Q000517:prevention & control; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003774:Dental Plaque Index; D012534:Dental Scaling; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D007834:Lasers; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000188:drug therapy / Q000517:prevention & control; D010510:Periodontal Diseases / Q000188:drug therapy / Q000517:prevention & control*; D010514:Periodontal Pocket / Q000188:drug therapy / Q000517:prevention & control; D010640:Phenothiazines / Q000627:therapeutic use; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D016745:Root Planing; D016896:Treatment Outcome
D010640:Phenothiazines; D017319:Photosensitizing Agents; C031637:phenothiazine