title: Additional effects of aPDT on nonsurgical periodontal treatment with doxycycline in type II diabetes: a randomized, controlled clinical trial.
abstract: The association of doxycycline and periodontal treatment in non-controlled diabetes mellitus (DM) has shown positive results on clinical and metabolic parameters. Antimicrobial photodynamic therapy (aPDT) is a local and painless antimicrobial treatment that can be applied in periodontal treatment without systemic risks. The aim of this study was to evaluate the potential improvement of aPDT on clinical and metabolic effects in patients with type 2 diabetes mellitus in conjunction with nonsurgical periodontal treatment plus doxycycline. Thirty patients with type 2 diabetes and diagnosis of chronic periodontitis were treated with scaling and root planning (SRP; N = 15) or SRP plus phenothiazine chloride photosensitizer-induced aPDT (SRP + aPDT, N = 15). Patients of both groups took doxycycline (100 mg/day) for 2 weeks and plaque index, bleeding on probe (BOP), probing pocket depth (PPD), suppuration, clinical attachment level (CAL), and glycated hemoglobin levels (HbA1c) were measured at baseline and 3 months after therapy. An improvement in clinical parameters such as PPD, CAL, S, and BOP between groups was observed but without statistical significance (p > 0.05). Intragroup analysis showed a significant reduction of HbA1c (8.5 ± 0.9 to 7.5 ± 0.1, p < 0.01) in the SRP + aPDT group. The differences of HbA1c between baseline and 3 months were greater for the SRP + aPDT (11.4 %) than SRP (10 %) (0.87 ± 0.9 and 0.4 ± 0.84 respectively; p < 0.05). A single application of the aPDT as an adjunct to periodontal treatment did not show additional benefits in the clinical parameters but resulted in a slight greater decrease in HbA1c.
authors.affiliation: School of Dentistry, Tiradentes University, Aracaju, SE, Brazil, gmacedo75@yahoo.com.br.
authors.forename: Guilherme de Oliveira
authors.initials: Gde O
authors.lastname: Macedo
authors.forename: Arthur B
authors.initials: AB
authors.lastname: Novaes
authors.forename: Sérgio L S
authors.initials: SL
authors.lastname: Souza
authors.forename: Mário
authors.initials: M
authors.lastname: Taba
authors.forename: Daniela B
authors.initials: DB
authors.lastname: Palioto
authors.forename: Márcio F M
authors.initials: MF
authors.lastname: Grisi
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D055113:Chronic Periodontitis / Q000097:blood / Q000188:drug therapy*; D003131:Combined Modality Therapy; D012534:Dental Scaling; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D004318:Doxycycline / Q000627:therapeutic use*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010514:Periodontal Pocket / Q000097:blood / Q000188:drug therapy; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D016745:Root Planing / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D004318:Doxycycline; D006442:Glycated Hemoglobin; D017319:Photosensitizing Agents; C517652:hemoglobin A1c protein, human