Full-mouth antimicrobial photodynamic therapy in Fusobacterium nucleatum-infected periodontitis patients.
BACKGROUND
The purpose of this study is to clinically and microbiologically evaluate the effect of photodynamic therapy (PDT) as a full-mouth procedure in Fusobacterium nucleatum-infected patients with periodontitis.


METHODS
In the present study, PDT is administered adjuvantly after scaling and root planing (SRP) to patients with localized chronic periodontitis (LCP). Twenty-four patients, in whom only F. nucleatum was detected by baseline polymerase chain reaction (PCR) after SRP, were randomly assigned to PDT and control groups. PDT was carried out once as a full-mouth disinfection in the test group. The control group was treated with the photosensitizer solution, but without laser irradiation. In all subjects, the clinical parameters plaque index, reddening, bleeding on probing (BOP), probing depth (PD), gingival recession, and clinical attachment level (CAL) were determined at the baseline examination and at 1, 4, and 12 weeks after PDT. Quantitative analysis of the F. nucleatum DNA concentration was performed by competitive PCR. All clinical indices were calculated for each test and control subject as were the median and interquartile range of each group.


RESULTS
In patients with LCP who received PDT treatment, significant reductions in reddening, BOP, and mean PD and CAL were observed during the observation period and with respect to controls. Four and 12 weeks after PDT, the mean PD and CAL showed significant differences from baseline values and from those of the control group. In the PDT group, 12 weeks after treatment, the F. nucleatum DNA concentration was found to be significantly reduced compared to the baseline level.


CONCLUSIONS
The results of this study show that the adjuvant application of the described PDT method is appropriate to reduce periodontal inflammatory symptoms and to successfully treat infection with F. nucleatum.
Sigusch
Bernd W
BW
Department of Conservative Dentistry, University Hospital Jena, Jena, Germany. bernd.w.sigusch@med.uni-jena.de
Engelbrecht
Marcus
M
Völpel
Andrea
A
Holletschke
Anne
A
Pfister
Wolfgang
W
Schütze
Juliane
J
D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000187:drug effects; D001439:Bacteroides / Q000187:drug effects; D055113:Chronic Periodontitis / Q000188:drug therapy* / Q000382:microbiology; D003131:Combined Modality Therapy; D003774:Dental Plaque Index; D012534:Dental Scaling; D005260:Female; D005500:Follow-Up Studies; D005674:Fusobacterium Infections / Q000188:drug therapy* / Q000382:microbiology; D016967:Fusobacterium nucleatum / Q000187:drug effects*; D005884:Gingival Hemorrhage / Q000188:drug therapy; D005889:Gingival Recession / Q000188:drug therapy; D005891:Gingivitis / Q000188:drug therapy; D006801:Humans; D054023:Lasers, Semiconductor / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000188:drug therapy; D010514:Periodontal Pocket / Q000188:drug therapy; D010640:Phenothiazines / Q000627:therapeutic use; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D016966:Porphyromonas gingivalis / Q000187:drug effects; D016745:Root Planing; D048373:Treponema denticola / Q000187:drug effects
D010640:Phenothiazines; D017319:Photosensitizing Agents; C031637:phenothiazine