title: Antimicrobial photodynamic therapy as an alternative to systemic antibiotics: results from a double-blind, randomized, placebo-controlled, clinical study on type 2 diabetics.
abstract: OBJECTIVE
  This double-blind, placebo-controlled clinical study compared multiple applications of the antimicrobial photodynamic therapy (aPDT) treatment protocol, to systemic doxycycline as adjuvant to scaling and root planing (SRP) on type 2 diabetic patients on clinical, systemic and immune-inflammatory outcomes.
  
  
  METHODS
  Thirty patients with Hba1c >7% were allocated in two groups, SRP + Doxy (n = 15) using systemic doxycycline 100 mg/day (14 days) and SRP + aPDT (n = 15) with multiple applications (0, 3, 7 and 14 days). Primary outcome was glycated haemoglobin levels (HbA1c). Clinical parameters: plaque score (PS), bleeding on probe, probing depth, suppuration, gingival recession, and clinical attachment level, percentage of pockets with desired clinical endpoint were measured at baseline and 3 months after therapy. Cytokine profile was assessed at 0, 1 and 3 month to measure IL1-β, TNF-α and TGF-β on gingival crevicular fluid.
  
  
  RESULTS
  No significant difference was detected on HbA1c, between treatments. The SRP + aPDT group showed advantage on reducing moderate pockets in single-rooted teeth at 3 months. SRP + aPDT presented better results at 3 months on IL1-β levels. There were no significant differences between TNF-α and TGF-β.
  
  
  CONCLUSIONS
  Both treatments improved clinical and systemic outcomes (Hba1c). SRP + aPDT performed better in moderate probing pocket depth on single-rooted teeth, reduced favourably inflammation in short term, and may be an alternative to systemic antibiotics. (Clinicaltrials.org ID NCT01595594).
authors.affiliation: Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Umberto D
authors.identifier: http://orcid.org/0000-0002-3759-1364
authors.initials: UD
authors.lastname: Ramos
authors.affiliation: Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Lauro G
authors.initials: LG
authors.lastname: Ayub
authors.affiliation: Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Danilo M
authors.initials: DM
authors.lastname: Reino
authors.affiliation: Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Márcio F M
authors.initials: MF
authors.lastname: Grisi
authors.affiliation: Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Mário
authors.initials: M
authors.lastname: Taba
authors.affiliation: Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Sérgio L S
authors.initials: SL
authors.lastname: Souza
authors.affiliation: Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Daniela B
authors.initials: DB
authors.lastname: Palioto
authors.affiliation: Department of Bucco-Maxillo-Facial Surgery and Traumatology and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Arthur B
authors.initials: AB
authors.lastname: Novaes
mesh_terms: D000900:Anti-Bacterial Agents; D003131:Combined Modality Therapy; D012534:Dental Scaling; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000188:drug therapy; D010778:Photochemotherapy; D016745:Root Planing
chemical_list: D000900:Anti-Bacterial Agents
keywords: antimicrobial photodynamic therapy; doxycycline; glycated haemoglobin A; interleukin-1; type 2 diabetes mellitus