title: Nonsurgical treatment of aggressive periodontitis with photodynamic therapy or systemic antibiotics. Three-month results of a randomized, prospective, controlled clinical study.
abstract: The aim of this randomized, controlled clinical study was to compare the short-term effects of nonsurgical periodontal therapy with the additional administration of systemic antibiotics (AB) and the same therapy with additional photodynamic therapy (PDT) in the treatment of patients with aggressive periodontitis (AP). Thirty-six patients with AP received full-mouth nonsurgical periodontal treatment (SRP) and were then randomly divided into two groups of 18 subjects each. Group AB received amoxicillin and metronidazole three times a day for 7 days. Group PDT received two applications of PDT on the day of SRP as well as at follow-up after 7 days. The following clinical parameters were measured at baseline and 3 months after therapy: plaque index (PLI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL). After 3 months, PD was significantly reduced in both groups (from 5.0±0.8 mm to 3.2±0.4 mm with AB, and 5.1±0.5 mm to 4.0±0.8 mm with PDT; both p<0.001), while AB revealed significantly lower values compared to PDT (p = 0.001). In both groups, GR was not significantly changed. CAL was significantly reduced in both groups (PDT: 5.7±0.8 mm to 4.7±1.1 mm; p=0.011; AB: 5.5±1.1 mm to 3.9±1.0 mm; p<0.001) and differed significantly between the groups (p=0.025). The number of residual pockets (PD ≥4 mm) and positive BOP was reduced by AB from 961 to 377, and by PDT from 628 to 394. Pockets with PD ≥7 mm were reduced by AB from 141 to 7, and by PDT from 137 to 61. After 3 months, both treatments led to statistically significant clinical improvements. The systemic administration of antibiotics, however, resulted in significantly higher reduction of PD and a lower number of deep pockets compared to PDT.
authors.affiliation: Department of Periodontology, Center for Dentistry and Oral Medicine, Philipps University, Marburg, Germany. arweiler@med.uni-marburg.de
authors.forename: Nicole B
authors.initials: NB
authors.lastname: Arweiler
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Pietruska
authors.forename: Ania
authors.initials: A
authors.lastname: Skurska
authors.forename: Ewa
authors.initials: E
authors.lastname: Dolińska
authors.forename: Jan K
authors.initials: JK
authors.lastname: Pietruski
authors.forename: Maximilian
authors.initials: M
authors.lastname: Bläs
authors.forename: Thorsten M
authors.initials: TM
authors.lastname: Auschill
authors.forename: Anton
authors.initials: A
authors.lastname: Sculean
mesh_terms: D000284:Administration, Oral; D000328:Adult; D010520:Aggressive Periodontitis / Q000188:drug therapy*; D000658:Amoxicillin / Q000008:administration & dosage; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D012534:Dental Scaling; D005260:Female; D006801:Humans; D054023:Lasers, Semiconductor / Q000627:therapeutic use; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000188:drug therapy; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000188:drug therapy; D010640:Phenothiazines / Q000627:therapeutic use*; D010778:Photochemotherapy; D017319:Photosensitizing Agents; D011446:Prospective Studies; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D010640:Phenothiazines; D017319:Photosensitizing Agents; D008795:Metronidazole; D000658:Amoxicillin