Antimicrobial Photodynamic Therapy as an Adjunct to Non‐Surgical Treatment of Aggressive Periodontitis: A Split‐Mouth Randomized Controlled Trial

• Published in: Journal of periodontology (1970) Vol. 86; no. 3; pp. 376 - 386
• Main Authors: Moreira, André L., Novaes, Arthur B., Grisi, Márcio F., Taba, Mario, Souza, Sérgio L., Palioto, Daniela B., Oliveira, Paula G., Casati, Marcio Z., Casarin, Renato C., Messora, Michel R.
• Format: Journal Article
• Language: English
• Published: United States American Academy of Periodontology 01-03-2015
• Subjects: Adolescent; Adult; Aggressive periodontitis; Aggressive Periodontitis - drug therapy; Aggressive Periodontitis - therapy; Bacterial Load - drug effects; Combined Modality Therapy; cytokines; Dental Plaque - microbiology; Dental Scaling - methods; Dentistry; Double-Blind Method; Female; Gingival Crevicular Fluid - immunology; Gram-Negative Anaerobic Bacteria - drug effects; Humans; Interleukin-10 - analysis; Interleukin-1beta - analysis; Lasers, Semiconductor - therapeutic use; Male; microbiology; Periodontal Attachment Loss - drug therapy; Periodontal Attachment Loss - therapy; Periodontal Pocket - drug therapy; Periodontal Pocket - microbiology; Periodontal Pocket - therapy; Phenothiazines - therapeutic use; photochemotherapy; Photochemotherapy - methods; photosensitizing agents; Photosensitizing Agents - therapeutic use; Root Planing - methods; Young Adult; microbiology; photosensitizing agents; cytokines; photochemotherapy; Aggressive periodontitis
• ISSN: 0022-3492; 1943-3670
• DOI: 10.1902/jop.2014.140392

Background: The management of aggressive periodontitis (AgP) represents a challenge for clinicians because there are no standardized protocols for an efficient control of the disease. This randomized controlled clinical trial evaluated the effects of repeated applications of antimicrobial photodynamic therapy (aPDT) adjunctive to scaling and root planing (SRP) in patients with AgP.
Methods: Using a split‐mouth design, 20 patients with generalized AgP were treated with aPDT + SRP (test group) or SRP only (control group). aPDT was applied at four periods. All patients were monitored for 90 days. Clinical, microbiologic, and immunologic parameters were statistically analyzed.
Results: In deep periodontal pocket analysis (probing depth [PD] ≥7 mm at baseline), the test group presented a decrease in PD and a clinical attachment gain significantly higher than the control group at 90 days (P <0.05). The test group also demonstrated significantly less periodontal pathogens of red and orange complexes and a lower interleukin‐1β/interleukin‐10 ratio than the control group (P <0.05).
Conclusion: The application of four sessions of aPDT, adjunctive to SRP, promotes additional clinical, microbiologic, and immunologic benefits in the treatment of deep periodontal pockets in single‐rooted teeth in patients with AgP.