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Wang P, Sun F, Ling X. Effectiveness of photodynamic therapy as an adjunctive treatment for periodontitis: A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:102036. [PMID: 39244026 DOI: 10.1016/j.jormas.2024.102036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Accepted: 09/04/2024] [Indexed: 09/09/2024]
Abstract
OBJECTIVE Periodontitis is a prevalent inflammatory disease affecting the supporting structures of teeth. While scaling and root planing (SRP) remains the gold standard for treatment, adjunctive therapies are being explored to enhance outcomes. This systematic review and meta-analysis aimed to evaluate the effectiveness of photodynamic therapy (PDT) as an adjunct to SRP in the treatment of periodontitis. METHODS A comprehensive literature search was conducted in PubMed, Embase, Web of Science, CNKI, Wanfang, and Weipu databases. Randomized controlled trials (RCTs) comparing SRP alone to SRP with adjunctive PDT were included. The primary outcomes were changes in clinical attachment level (CAL) and probing depth (PD). Secondary outcomes included plaque index (PI). Random-effects models were used for meta-analysis, and heterogeneity was assessed using I² statistics. RESULTS Eighteen RCTs met the inclusion criteria. Meta-analysis revealed that adjunctive PDT significantly improved CAL (SMD: -0.16; 95% CI: -0.40, -0.07; P < 0.001; I² = 60.7%) and PD (SMD: -0.55; 95% CI: -0.97, -0.13; P < 0.001; I² = 76.2%) compared to SRP alone. PI also showed improvement with adjunctive PDT (SMD: -0.40; 95% CI: -0.67, -0.14; P = 0.072; I² = 43.0%). Egger's test indicated a borderline significant publication bias for CAL, while no significant publication bias for PD. CONCLUSION This meta-analysis provides evidence that PDT as an adjunct to SRP can significantly improve clinical outcomes in periodontitis treatment. However, the high heterogeneity observed suggests that optimal PDT protocols need further investigation. Future research should focus on standardizing PDT parameters and exploring its long-term effects.
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Affiliation(s)
- Peng Wang
- Department of Periodontology, Shaoxing Stomatological Hospital, Shaoxing City, 312000, PR China
| | - Fei Sun
- Department of Periodontology, Shaoxing Stomatological Hospital, Shaoxing City, 312000, PR China
| | - Xiaoxu Ling
- Department of Endodontics, Shaoxing Stomatological Hospital, Shaoxing City, 312000, PR China.
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Roy Chowdhury U, Kamath D, Rao P, Shenoy M S, Shenoy R. Indocyanine green based antimicrobial photodynamic therapy as an adjunct to non-surgical periodontal treatment in periodontal maintenance patients: a clinico-microbiological study. F1000Res 2024; 12:949. [PMID: 39296350 PMCID: PMC11409656 DOI: 10.12688/f1000research.133230.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2024] [Indexed: 09/21/2024] Open
Abstract
Background: Antimicrobial Photodynamic therapy for the treatment of periodontitis is being increasingly gaining attention but at present, very limited data are available on the clinical and microbiological outcomes obtained following Indocyanine Green as the photosensitizer in Maintenance patients. The objective was to evaluate the efficiency of Indocyanine(ICG)-green based photodynamic therapy as an adjunct to scaling and root planing in patients enrolled in maintenance therapy. Methodology: Using a split mouth study design, 24 participants enrolled in the maintenance therapy, having diagnosed as Periodontitis, were randomly subjected to scaling and root planing(SRP). The test group additionally received ICG-based (Aurogreen ®, Aurolabs, Madurai, India,1mg/ml) aPDT with an 810nm diode laser. Clinical assessment of Plaque index, modified Sulcus bleeding index, Probing pocket depth, Clinical loss of attachment and microbiological analysis of A. actinomycetemcomitans, P. gingivalis, T. forsythia and F.nucleatum were performed at baseline and 3 months after treatment. Results: It was observed that although there was no significant difference between the test and control group at baseline and 3 months, there was a statistically significant reduction in the mean values in both the groups at 3 months. Microbiological analysis showed substantial reduction in detection frequency of the bacteria assessed at 3 months in both the groups. Conclusion: Within the limits of the study, ICG-based aPDT did not show additional advantage over SRP alone at 3 months, though it could be a promising treatment modality in maintenance patients in terms of patient comfort and the treatment time taken. More randomised clinical trials should be employed to understand the exact mode of action of ICG based aPDT and its role in treatment of periodontal disease.
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Affiliation(s)
- Urbashi Roy Chowdhury
- Ex-Post graduate Trainee, Periodontology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Deepa Kamath
- Professor, Periodontology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Pooja Rao
- Assosiate Professior, Microbiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Suchitra Shenoy M
- Professor and Head, Microbiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Ramya Shenoy
- Professor and Head, Public Health Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
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Jervøe-Storm PM, Bunke J, Worthington HV, Needleman I, Cosgarea R, MacDonald L, Walsh T, Lewis SR, Jepsen S. Adjunctive antimicrobial photodynamic therapy for treating periodontal and peri-implant diseases. Cochrane Database Syst Rev 2024; 7:CD011778. [PMID: 38994711 PMCID: PMC11240860 DOI: 10.1002/14651858.cd011778.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
BACKGROUND Periodontitis and peri-implant diseases are chronic inflammatory conditions occurring in the mouth. Left untreated, periodontitis progressively destroys the tooth-supporting apparatus. Peri-implant diseases occur in tissues around dental implants and are characterised by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone. Treatment aims to clean the pockets around teeth or dental implants and prevent damage to surrounding soft tissue and bone, including improvement of oral hygiene, risk factor control (e.g. encouraging cessation of smoking) and surgical interventions. The key aspect of standard non-surgical treatment is the removal of the subgingival biofilm using subgingival instrumentation (SI) (also called scaling and root planing). Antimicrobial photodynamic therapy (aPDT) can be used an adjunctive treatment to SI. It uses light energy to kill micro-organisms that have been treated with a light-absorbing photosensitising agent immediately prior to aPDT. OBJECTIVES To assess the effects of SI with adjunctive aPDT versus SI alone or with placebo aPDT for periodontitis and peri-implant diseases in adults. SEARCH METHODS We searched the Cochrane Oral Health Trials Register, CENTRAL, MEDLINE, Embase, two other databases and two trials registers up to 14 February 2024. SELECTION CRITERIA We included randomised controlled trials (RCTs) (both parallel-group and split-mouth design) in participants with a clinical diagnosis of periodontitis, peri-implantitis or peri-implant disease. We compared the adjunctive use of antimicrobial photodynamic therapy (aPDT), in which aPDT was given after subgingival or submucosal instrumentation (SI), versus SI alone or a combination of SI and a placebo aPDT given during the active or supportive phase of therapy. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodological procedures, and we used GRADE to assess the certainty of the evidence. We prioritised six outcomes and the measure of change from baseline to six months after treatment: probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment level (CAL), gingival recession (REC), pocket closure and adverse effects related to aPDT. We were also interested in change in bone level (for participants with peri-implantitis), and participant satisfaction and quality of life. MAIN RESULTS We included 50 RCTs with 1407 participants. Most studies used a split-mouth study design; only 18 studies used a parallel-group design. Studies were small, ranging from 10 participants to 88. Adjunctive aPDT was given in a single session in 39 studies, in multiple sessions (between two and four sessions) in 11 studies, and one study included both single and multiple sessions. SI was given using hand or power-driven instrumentation (or both), and was carried out prior to adjunctive aPDT. Five studies used placebo aPDT in the control group and we combined these in meta-analyses with studies in which SI alone was used. All studies included high or unclear risks of bias, such as selection bias or performance bias of personnel (when SI was carried out by an operator aware of group allocation). We downgraded the certainty of all the evidence owing to these risks of bias, as well as for unexplained statistical inconsistency in the pooled effect estimates or for imprecision when evidence was derived from very few participants and confidence intervals (CI) indicated possible benefit to both intervention and control groups. Adjunctive aPDT versus SI alone during active treatment of periodontitis (44 studies) We are very uncertain whether adjunctive aPDT during active treatment of periodontitis leads to improvement in any clinical outcomes at six months when compared to SI alone: PPD (mean difference (MD) 0.52 mm, 95% CI 0.31 to 0.74; 15 studies, 452 participants), BOP (MD 5.72%, 95% CI 1.62 to 9.81; 5 studies, 171 studies), CAL (MD 0.44 mm, 95% CI 0.24 to 0.64; 13 studies, 414 participants) and REC (MD 0.00, 95% CI -0.16 to 0.16; 4 studies, 95 participants); very low-certainty evidence. Any apparent differences between adjunctive aPDT and SI alone were not judged to be clinically important. Twenty-four studies (639 participants) observed no adverse effects related to aPDT (moderate-certainty evidence). No studies reported pocket closure at six months, participant satisfaction or quality of life. Adjunctive aPDT versus SI alone during supportive treatment of periodontitis (six studies) We were very uncertain whether adjunctive aPDT during supportive treatment of periodontitis leads to improvement in any clinical outcomes at six months when compared to SI alone: PPD (MD -0.04 mm, 95% CI -0.19 to 0.10; 3 studies, 125 participants), BOP (MD 4.98%, 95% CI -2.51 to 12.46; 3 studies, 127 participants), CAL (MD 0.07 mm, 95% CI -0.26 to 0.40; 2 studies, 85 participants) and REC (MD -0.20 mm, 95% CI -0.48 to 0.08; 1 study, 24 participants); very low-certainty evidence. These findings were all imprecise and included no clinically important benefits for aPDT. Three studies (134 participants) reported adverse effects: a single participant developed an abscess, though it is not evident whether this was related to aPDT, and two studies observed no adverse effects related to aPDT (moderate-certainty evidence). No studies reported pocket closure at six months, participant satisfaction or quality of life. AUTHORS' CONCLUSIONS Because the certainty of the evidence is very low, we cannot be sure if adjunctive aPDT leads to improved clinical outcomes during the active or supportive treatment of periodontitis; moreover, results suggest that any improvements may be too small to be clinically important. The certainty of this evidence can only be increased by the inclusion of large, well-conducted RCTs that are appropriately analysed to account for change in outcome over time or within-participant split-mouth study designs (or both). We found no studies including people with peri-implantitis, and only one study including people with peri-implant mucositis, but this very small study reported no data at six months, warranting more evidence for adjunctive aPDT in this population group.
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Affiliation(s)
- Pia-Merete Jervøe-Storm
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | - Jennifer Bunke
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Ian Needleman
- Unit of Periodontology and International Centre for Evidence-Based Oral Health, UCL Eastman Dental Institute, London, UK
| | - Raluca Cosgarea
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
- Department of Periodontology and Peri-implant Diseases, Philips University Marburg, Marburg, Germany
- Clinic for Prosthetic Dentistry, University Iuliu-Hatieganu, Cluj-Napoca, Romania
| | - Laura MacDonald
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Tanya Walsh
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Sharon R Lewis
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University Hospital Bonn, Bonn, Germany
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Lalli AK, Dhingra S, Lalli AS, Kaur G, Gupta H, Goyal S. Clinical Evaluation of Diode Laser as an Adjunct to Scaling and Root Planing in Patients With Chronic Periodontitis and Type II Diabetes Mellitus: A Split-Mouth Study. Cureus 2024; 16:e54178. [PMID: 38496103 PMCID: PMC10941804 DOI: 10.7759/cureus.54178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 03/19/2024] Open
Abstract
INTRODUCTION The primary goal of periodontal therapy is to arrest the inflammatory disease process which is done by non-surgical and surgical therapies in order to reduce the microorganisms. The outcome of periodontal therapy may not reveal the desired results owing to inaccessible areas for instrumentation, pathogenicity, resistance of the microorganisms, or even due to compromised host response to the treatment. Thus, adjunctive laser therapy has been proposed as a novel treatment modality in the treatment of periodontal disease. Aim: The aim of this study was to clinically evaluate the effect of a 980 nm diode laser (DEN10B; Wuhan Gigaa Optronics Technology Co., Ltd., Wuhan, China) therapy as an adjunct to scaling and root planing in patients with chronic periodontitis and type II diabetes. METHODS Twenty patients were divided into two groups in a split-mouth study design. Group I (Control) comprised mechanical debridement alone and Group II (test) comprised mechanical debridement followed by adjunctive laser therapy. The clinical parameters were recorded at baseline, six weeks, and three months, and the results were analyzed. RESULTS There was a significant improvement in gingival and plaque index in the test group. Though there was no significant improvement in probing pocket depth and clinical attachment, the results in the test group were superior relative to the control group. CONCLUSION Non-surgical periodontal therapy with adjunctive use of diode laser is effective in the management of generalized chronic periodontitis in patients with type II diabetes which led to a significant reduction in plaque score, gingival index score, probing pocket depth, and gain in clinical attachment level.
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Affiliation(s)
- Agamjot K Lalli
- Periodontology, Sri Guru Ram Das Institute of Dental Sciences & Research, Amritsar, IND
| | - Sachin Dhingra
- Periodontology, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | | | - Gurleen Kaur
- Emergency Medicine, District Hospital, Mohali, IND
| | - Harinder Gupta
- Periodontology, Government Dental College and Hospital, Patiala, Patiala, IND
| | - Sanjay Goyal
- Medicine, Government Medical College, Patiala, Patiala, IND
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Mišković I, Kuiš D, Špalj S, Pupovac A, Prpić J. Periodontal Health Status in Adults Exposed to Tobacco Heating System Aerosol and Cigarette Smoke vs. Non-Smokers: A Cross-Sectional Study. Dent J (Basel) 2024; 12:26. [PMID: 38392230 PMCID: PMC10887685 DOI: 10.3390/dj12020026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/21/2024] [Accepted: 01/24/2024] [Indexed: 02/24/2024] Open
Abstract
Tobacco heating systems (THS) are new products on the market, advertised as a less harmful alternative for smokers, in which tobacco is heated and not burned like in conventional cigarettes. This research explored the effect on periodontal tissues in contact with heating and burning tobacco residual products (smoke and tobacco). METHODS The sample included 66 subjects, patients of the Clinic of Dentistry in Rijeka, Croatia, aged 26-56 (median 38), 64% females. Three age- and gender-matched groups were formed (each N = 22): non-smokers, classic cigarettes smokers and THS smokers. Probing depth (PD) and clinical attachment loss (CAL) were primary research parameters. RESULTS Three groups differed in average PD and CAL (p ≤ 0.002), with cigarette smokers having the highest and non-smokers the lowest values (p ≤ 0.002). THS consumers generally had lower values of periodontal indices than smokers, but only CAL differed significantly (p = 0.011). Periodontal indices CAL and PD were worse in THS consumers than non-smokers, but they did not reach a level of statistical significance. Cigarette smoking was the only predictor of periodontitis (average CAL ≥ 4 mm) in logistic regression models, with an odds ratio of 4.7 (95% confidence interval 1.2-18.3; p = 0.027). CONCLUSIONS Exposure to nicotine-containing aerosol of THS in adults has a less harmful effect on periodontal tissues, measurable through periodontal indices (PD and CAL), compared to burning tobacco of conventional cigarettes. THS, presented as an alternative product to classic cigarettes, also has a detrimental effect on the periodontium.
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Affiliation(s)
- Ivana Mišković
- Clinical Hospital Centre Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
| | - Davor Kuiš
- Clinical Hospital Centre Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
- Department of Periodontology, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40-42, 51000 Rijeka, Croatia
- Department of Dental Medicine, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia
| | - Stjepan Špalj
- Clinical Hospital Centre Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
- Department of Dental Medicine, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40-42, 51000 Rijeka, Croatia
| | - Aleksandar Pupovac
- Department of Periodontology, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40-42, 51000 Rijeka, Croatia
| | - Jelena Prpić
- Clinical Hospital Centre Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
- Department of Periodontology, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40-42, 51000 Rijeka, Croatia
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Isil T, Ozlem K, Defne BH, Eray GM, Abdurrahim K. Toxicity evaluation of indocyanine green mediated photodynamic therapy. Photodiagnosis Photodyn Ther 2023; 44:103754. [PMID: 37595656 DOI: 10.1016/j.pdpdt.2023.103754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/13/2023] [Accepted: 08/15/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND The aim of the study is to determine the cytotoxic, genotoxic and inflammatory effects of indocyanine green (ICG) mediated photodynamic therapy (PDT) in direct contact with L-929 mouse fibroblast cells and over a dentin barrier. METHODS Eight groups were evaluated; control (C), group with a dentin barrier (D), ICG applied directly on the cells (ICG), ICG applied over a dentin barrier (D-ICG), only laser applied (L), laser applied over a dentin barrier (D-L), ICG and laser applied directly on the cells (ICG-L), ICG and laser applied over a dentin barrier (D-ICG-L). Cell viability was evaluated via ATP Assay, DNA damage was evaluated via Comet Assay, and inflammatory markers IL-1β and TNF-α were assessed via ELISA test. RESULTS Cell viability decreased in group ICG (p<0.001). Cell viability decrease was higher in Group ICG-L (p<0.001). Cell viability decrease was lower in group D-ICG-L (p>0.05). Group L caused an increase in cell number (p<0.001). DNA damage was observed in ICG, D-ICG, and ICG-L groups (p<0.05). None of the groups displayed an increase of inflammatory markers IL-1β and TNF-α (p>0.05). CONCLUSIONS The presence of dentin between ICG and cells acted as a barrier and protected the cells. ICG-mediated PDT did not cause any cytotoxic, genotoxic or inflammatory effect. The use of ICG-mediated PDT for cavity disinfection is acceptable, but at this concentration its use in periodontal pocket disinfection is not recommended due to its cytotoxic and genotoxic properties.
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Affiliation(s)
- Turp Isil
- BezmialemVakif University, Faculty of Dentistry, Department of Prosthodontics, Istanbul, Turkey
| | - Kara Ozlem
- BezmialemVakif University, Faculty of Dentistry, Department of Prosthodontics, Istanbul, Turkey.
| | | | - Guler Metin Eray
- University of Health Sciences Turkey, Hamidiye School of Medicine, Department of Medical Biochemistry, Istanbul, Turkey; University of Health Sciences Turkey, Hamidiye Faculty of Medicine, Haydarpasa Numune Health Application and Research Center, Department of Medical Biochemistry, Istanbul, Turkey
| | - Kocyigit Abdurrahim
- BezmialemVakif University, Faculty of Medicine, Department of Medical Biochemistry, Istanbul, Turkey
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Rodrigues RD, Araujo NS, Filho JMP, Vieira CLZ, Ribeiro DA, Dos Santos JN, Cury PR. Photodynamic therapy as adjunctive treatment of single-rooted teeth in patients with grade C periodontitis: A randomized controlled clinical trial. Photodiagnosis Photodyn Ther 2023; 44:103776. [PMID: 37657680 DOI: 10.1016/j.pdpdt.2023.103776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/22/2023] [Accepted: 08/29/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND The present study aimed to evaluate the adjunctive effect of an antimicrobial photodynamic therapy (aPDT) protocol on single-rooted teeth of patients with grade C periodontitis. METHODS Sixty-four single-rooted teeth (14 patients) were included in each group of this double-blinded split-mouth randomized clinical trial. The teeth were randomly divided into scaling and root planing + aPDT (test group) and scaling and root planing+sham aPDT (control group). The aPDT protocol consisted of incubation with 1% methylene blue for 5 min, rinsing, and application of a diode laser (wavelength of 660 nm, power of 100 mW) for 10 s. aPDT was repeated after 7 days. Bleeding on probing (BoP), probing depth (PD), gingival recession (GR), and clinical attachment loss (CAL) were recorded before and 3 months after treatment. A 5% significance level was adopted for statistical analysis. RESULTS Final PD was significantly (P = 0.02) lower in the test group (2.87 ± 1.40 mm) compared to control (3.12 ± 1.69 mm). The test group showed a significantly higher percentage of sites with PD≤4 mm and concomitant BoP compared to control (91%x86%;P < 0.001). At sites with baseline PD>4 mm, final PD and CAL were significantly (P = 0.01) lower in the test group (4.11 ± 1.66 and 4.89 ± 2.49 mm, respectively) compared to control (4.88 ± 1.99 and 5.89 ± 2.74 mm, respectively). CONCLUSIONS aPDT combined with scaling and root planning provided slightly better periodontal clinical results than the latter procedure alone, exerting a superior effect at sites with greater baseline PD. aPDT might be used as adjunctive treatment in grade C periodontitis affecting single-rooted teeth since it improves the response to conventional periodontal treatment.
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Affiliation(s)
- Rafael Drummond Rodrigues
- Postgraduate Program in Dentistry and Health, School of Dentistry, Faculdade de Odontologia, Avenida Araújo Pinho, Federal University of Bahia, Av. Araujo Pinho, 62, CEP: 4110-150 62, Canela 40110-150, Salvador, Bahia, Brazil
| | - Nara Santos Araujo
- Postgraduate Program in Biotechnology, Northeast Biotechnology Network (RENORBIO), Federal University of Bahia, Av. Araujo Pinho, 62, CEP 4110-160, Salvador, Bahia, Brazil
| | - Jorge Moreira Pinto Filho
- Postgraduate Program in Dentistry and Health, School of Dentistry, Faculdade de Odontologia, Avenida Araújo Pinho, Federal University of Bahia, Av. Araujo Pinho, 62, CEP: 4110-150 62, Canela 40110-150, Salvador, Bahia, Brazil
| | - Carolina Letícia Zilli Vieira
- Department of Environmental Health, School of Public Health, Harvard T.H. Chan, 401 Park Dr Landmark Center West 420 Room, Boston, MA 02215, USA
| | - Daniel Araki Ribeiro
- Department of Biosciences, Federal University of São Paulo, Av. Ana Costa, 95 - Vila Mathias, CEP: 11060-001, Santos, São Paulo, Brazil
| | - Jean Nunes Dos Santos
- Postgraduate Program in Dentistry and Health, School of Dentistry, Faculdade de Odontologia, Avenida Araújo Pinho, Federal University of Bahia, Av. Araujo Pinho, 62, CEP: 4110-150 62, Canela 40110-150, Salvador, Bahia, Brazil
| | - Patricia Ramos Cury
- Postgraduate Program in Dentistry and Health, School of Dentistry, Faculdade de Odontologia, Avenida Araújo Pinho, Federal University of Bahia, Av. Araujo Pinho, 62, CEP: 4110-150 62, Canela 40110-150, Salvador, Bahia, Brazil.
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8
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Al-Kheraif AA, Javed R, Al-Momani MM, Wasi A, Khan AA. Effectiveness of photodynamic therapy adjunct to oral debridement in improving clinical, microbiological, and pain in necrotizing ulcerative gingivitis. JOURNAL OF BIOPHOTONICS 2023; 16:e202300197. [PMID: 37369626 DOI: 10.1002/jbio.202300197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/18/2023] [Accepted: 06/23/2023] [Indexed: 06/29/2023]
Abstract
To evaluate the efficacy of photodynamic therapy (PDT) as adjunctive to oral debridement (OD) in the improvement of clinical, microbiological, and pain in patients with necrotizing ulcerative gingivitis (NUG). Patients with NUG were split into two groups: Group-OD + PDT received PDT with OD, while Group-OD underwent OD alone. Clinical inflammatory parameters including full mouth plaque scores (FMPS), full mouth bleeding scores (FMBS), and probing depth (PD) were assessed. Fusobacterium nucleatum and Prevotella intermedia were analyzed using the polymerase chain reaction technique. Pain examination was done using various pain scales. Group PDT + OD showed more reduction in FMPS, FMBS, and greater reduction in F. nucleatum and P. intermedia count compared to group OD at 12 weeks follow up (p < 0.01). Group PDT + OD showed significantly lower pain scores at 12 weeks (p < 0.05). PDT was more effective in improving clinical parameters, and reducing bacterial counts and pain in NUG patients than dental scaling alone.
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Affiliation(s)
- Abdulaziz A Al-Kheraif
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ravish Javed
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Mahmoud Al-Momani
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Aisha Wasi
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Aftab Ahmed Khan
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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9
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Brinar S, Skvarča A, Gašpirc B, Schara R. The effect of antimicrobial photodynamic therapy on periodontal disease and glycemic control in patients with type 2 diabetes mellitus. Clin Oral Investig 2023; 27:6235-6244. [PMID: 37672083 PMCID: PMC10560165 DOI: 10.1007/s00784-023-05239-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/23/2023] [Indexed: 09/07/2023]
Abstract
OBJECTIVES This study is aimed at determining the effect of concomitant antimicrobial photodynamic therapy (aPTD) on periodontal disease and glycaemic control in patients with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS Twenty-four patients with T2DM were enrolled in the study. Periodontal clinical parameters were assessed by measuring probing pocket depth (PPD), clinical attachment loss (CAL), gingival recession (GR), full-mouth bleeding score (FMBS), full-mouth plaque score (FMPS), and full-mouth sulcus bleeding score (FMSBS). Glycated haemoglobin A1c (HbA1c) was measured. To determine the presence of the following periodontal pathogenic bacteria, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, subgingival plaque samples were taken from two periodontal pockets per jaw with the greatest PPD using paper tips. Patients were randomly divided into the test and control group. In the test group, full-mouth disinfection was performed in combination with aPTD. In the control group, only full-mouth disinfection was performed. RESULTS The results showed an improvement in periodontal clinical parameters in both groups. The difference between the groups in favour of the test group was statistically significant for BOP. The HbA1c level decreased in both groups. The difference was not statistically significant. The results of the microbiological analysis suggest that the presence of periodontal pathogenic bacteria is lower with additional antimicrobial photodynamic therapy with statistically significant difference for T. forsythia. CONCLUSIONS Additional aPDT causes a significant reduction in BoP in the proportion of positive sites for periodontal pathogens. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT05816941. CLINICAL RELEVANCE aPTD is a noninvasive adjunctive therapy that can positively influence the periodontal treatment outcome.
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Affiliation(s)
- Sara Brinar
- Department of Oral Medicine and Periodontology, University Medical Center Ljubljana, Ljubljana, Slovenia
- Community Health Centre Murska Sobota, Murska Sobota, Slovenia
| | - Aleš Skvarča
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Boris Gašpirc
- Department of Oral Medicine and Periodontology, University Medical Center Ljubljana, Ljubljana, Slovenia
- Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Rok Schara
- Department of Oral Medicine and Periodontology, University Medical Center Ljubljana, Ljubljana, Slovenia.
- Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
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Costa FO, Esteves Lima RP, Costa AM, Costa AA, Mattos Pereira GH, Cortelli SC, Cortelli JR, Magalhães Cyrino R, Aparecida Silva T, Miranda Cota LO. Adjunctive effects of photodynamic therapy using indocyanine green in residual pockets during periodontal maintenance therapy: A split-mouth randomized controlled trial. J Periodontol 2023; 94:1100-1111. [PMID: 37051740 DOI: 10.1002/jper.22-0672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/24/2023] [Accepted: 03/25/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Prospective studies have reported conflicting results regarding the adjunctive effect of antimicrobial photodynamic therapy (aPDT) on clinical and microbiological parameters in individuals under periodontal maintenance therapy (PMT). This study aimed to evaluate the clinical and microbiological adjunctive effects of aPDT using indocyanine green (ICG) in residual sites with probing depth (PD) ≥5 mm during PMT in comparison with scaling and root planing (SRP) alone. METHODS A split-mouth randomized controlled clinical trial was conducted with 24 individuals in a PMT program. Contralateral quadrants with eligible residual sites were randomly assigned to either SRP + aPDT (test group) or SRP alone (control). aPDT included ICG dye and diode laser (909 nm) performed together with SRP and repeated 15 days after. Periodontal clinical parameters, periodontal inflamed surface area (PISA) index, and subgingival biofilm samples were collected at baseline (T1), 3 (T2), and 6 months later (T3). Microbiological analyses were performed by quantitative real-time polymerase chain reaction. RESULTS Significant improvements were observed in all clinical and microbiological parameters in both groups from T1 to T3. However, no significant differences were observed regarding plaque index, PD, and clinical attachment level. Test group showed significantly greater reductions in bleeding on probing (BOP), PISA index, and Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans levels, when compared with controls. CONCLUSIONS Both treatments resulted in significant clinical periodontal improvements, but with no significant differences between groups except from inflammation parameters. aPDT using ICG resulted in significant reductions in BOP and PISA index, as well as in P. gingivalis and A. actinomycetemcomitans levels.
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Affiliation(s)
- Fernando Oliveira Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Adriana Moreira Costa
- Department of Periodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Amanda Almeida Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Sheila Cavalca Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - José Roberto Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Renata Magalhães Cyrino
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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11
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Al-Kheraif AA, Javed R, Al-Momani MM, Wasi A, Mohamed BA, Khan AA. Effectiveness of photodynamic therapy on clinical and biomarker related periodontal parameters and oral health related quality of life (OHRQoL) in Parkinson's disease patients with stage III periodontitis. Photodiagnosis Photodyn Ther 2023; 43:103690. [PMID: 37422202 DOI: 10.1016/j.pdpdt.2023.103690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/23/2023] [Accepted: 07/05/2023] [Indexed: 07/10/2023]
Abstract
AIMS To evaluate the clinical, radiographic, immune modulatory biomarkers and quality of life with the application of photodynamic therapy (PDT) as an adjunctive treatment to dental scaling and root planing (SRP) in patients with chronic periodontitis and Parkinson's disease. METHODOLOGY Individuals who had a confirmed diagnosis of stage III periodontitis and stage 4 Parkinson's disease according to Hoehn and Yahr scale were involved in this study. The participants were divided into two groups: Group SRP (n = 25) received traditional dental scaling procedure including full-mouth debridement and disinfection, and Group PDT + SRP (n = 25) received both traditional cleaning procedures along with adjunctive chloro‑aluminum phthalocyanine (CAPC) gel (0.005% concentration) mediated PDT. CAPC photosensitizer was activated using a diode laser (wavelength=640 nm, energy=4 J, 150 mW power, and overall power density of 300 J/cm2) for 60 s. The study measured clinical parameters such as plaque score (PI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), and radiographic alveolar bone loss (ABL). Proinflammatory cytokine levels such as interleukin (IL)-6 and tumor necrosis factor alpha (TNF-α) and oral health related quality of life were also assessed. RESULTS The mean age of patients in Group SRP was 73.3 years, while the mean age in Group PDT + SRP was 71.6 years. The PDT + SRP group showed a significant reduction in all clinical parameters at 6 and 12 months compared to the SRP group alone (p < 0.05). IL-6 and TNF-α levels were significantly reduced in the PDT + SRP group at 6 months compared to the SRP group alone (p < 0.05). However, at 12 months, both groups showed comparable TNF-α levels. The results showed that Group PDT + SRP had significantly lower OHIP scores compared to Group SRP, with a mean difference of 4.55 (95% confidence interval [CI]: 1.98 to 7.12) (p < 0.01). CONCLUSION Combined SRP with PDT showed significant improvement compared to SRP alone in terms of clinical parameters, cytokine levels, and oral health-related quality of life in individuals diagnosed with stage III periodontitis associated with Parkinson's disease.
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Affiliation(s)
- Abdulaziz A Al-Kheraif
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | - Ravish Javed
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Mahmoud Al-Momani
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Aisha Wasi
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Badreldin A Mohamed
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Aftab Ahmed Khan
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Silva PGBD, Guimarães L, Oliveira F, Miranda LO, Esteves RP. The effect of antimicrobial photodynamic therapy adjunct to non-surgical periodontal therapy on the treatment of periodontitis in individuals with type 2 diabetes mellitus: a systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2023; 42:103573. [PMID: 37062511 DOI: 10.1016/j.pdpdt.2023.103573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND The purpose of the present systematic review and meta-analysis was to assess the impact of antimicrobial photodynamic therapy adjunct to non-surgical periodontal treatment on individuals with type 2 diabetes mellitus. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed. Searches were carried out in six databases without restriction regarding publication year. Studies comparing periodontal clinical parameters among individuals submitted to non-surgical periodontal therapy associated with antimicrobial photodynamic therapy and a control group of individuals submitted to only non-surgical periodontal treatment were included. Study selection, data extraction, and risk of bias assessment (RoB 2.0) were performed by two review authors. Meta-analysis was performed. Mean difference (MD) and 95% confidence interval (CI) were provided. RESULTS Two hundred and five studies were identified and 11 studies were included. The meta-analysis demonstrated that antimicrobial photodynamic therapy adjunctive to periodontal therapy, in individuals with diabetes, resulted in a greater reduction of bleeding on probing at 6 months and in probing depth at 3 and 6 months in comparison to periodontal treatment alone (p<0.05). The included studies exhibited low risk of bias. CONCLUSION Antimicrobial photodynamic therapy adjunct to periodontal therapy contributes to the improvement of periodontal clinical parameter bleeding on probing and probing depth in individuals with type 2 diabetes mellitus.
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Affiliation(s)
- Pierre Geraldo Braz da Silva
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, School of Dentistry, Federal University de Minas Gerais. Antônio Carlos Avenue 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil, zip code 31270-901
| | - Lucas Guimarães
- Department of Child and Adolescent Oral Health, School of Dentistry, Federal University of Minas Gerais. Antônio Carlos Avenue 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil, zip code 31270-901
| | - Fernando Oliveira
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, School of Dentistry, Federal University de Minas Gerais. Antônio Carlos Avenue 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil, zip code 31270-901
| | - Luís Otávio Miranda
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, School of Dentistry, Federal University de Minas Gerais. Antônio Carlos Avenue 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil, zip code 31270-901
| | - Rafael Paschoal Esteves
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, School of Dentistry, Federal University de Minas Gerais. Antônio Carlos Avenue 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil, zip code 31270-901.
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Sezer B, Kodaman Dokumacıgil N, Kaya R, Güven S, Türkkan ÖN, Çiçek N, Alpay H, Kargül B. Association between serum biomarkers and oral health status in children with chronic kidney disease: A cross-sectional study. Clin Oral Investig 2023:10.1007/s00784-023-04989-1. [PMID: 37014503 DOI: 10.1007/s00784-023-04989-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/28/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the association between serum biomarkers and oral health parameters in children with chronic kidney disease (CKD). MATERIALS AND METHODS Serum hemoglobin, blood urea nitrogen, serum creatinine, calcium, parathormone, magnesium, and phosphorus levels were measured in 62 children with CKD aged between 4 and 17 years. Intraoral examinations of the patients were performed by two different pediatric dentists. Dental caries was assessed using the decayed-missing-filled-teeth (DMFT/dmft) indexes, and oral hygiene was assessed using the debris (DI), calculus (CI), and simplified oral hygiene (OHI-S) indexes. Spearman's rho coefficient and generalized linear modeling were used to examine the association between serum biomarkers and oral health parameters. RESULTS The results of the study showed that there were negative and statistically significant correlations between serum hemoglobin and creatinine levels and dmft scores in pediatric patients with CKD (p = 0.021 and p = 0.019, respectively). Furthermore, blood urea nitrogen levels and DI and OHI-S scores (p = 0.047 and p = 0.050, respectively); serum creatinine levels and DI, CI, and OHI-S scores (p = 0.005, p = 0.047, p = 0.043, respectively); and parathormone levels and CI and OHI-S scores (p = 0.001 and p = 0.017, respectively) were found to be positively and statistically significantly related. CONCLUSIONS There are associations between various serum biomarker levels and dental caries and oral hygiene parameters in pediatric patients with CKD. CLINICAL RELEVANCE The impact of changes in serum biomarkers on oral and dental health is important for dentists' and medical professionals' approaches to patients' oral and systemic health.
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Affiliation(s)
- Berkant Sezer
- Department of Pediatric Dentistry, School of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye.
| | - Nur Kodaman Dokumacıgil
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Türkiye
| | - Remziye Kaya
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Türkiye
| | - Serçin Güven
- Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Marmara University, Istanbul, Türkiye
| | - Özde Nisa Türkkan
- Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Marmara University, Istanbul, Türkiye
| | - Neslihan Çiçek
- Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Marmara University, Istanbul, Türkiye
| | - Harika Alpay
- Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Marmara University, Istanbul, Türkiye
| | - Betül Kargül
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Türkiye
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14
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Alqerban A, Asiri SN, Alghabban R, Alharbi F, Almalki A, Aljhani AS, Bukhary F, Abdelrahim R, Alkhtani F, Samran A. Periodontal, Microbiological, and Proinflammatory Cytokines Levels in Fixed Orthodontics Patients Treated with Photodynamic Therapy Adjunct to Full Mouth Scaling. Photobiomodul Photomed Laser Surg 2023; 41:133-139. [PMID: 36927049 DOI: 10.1089/photob.2022.0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Objective: To assess the efficiency of photodynamic therapy (PDT) adjunct to full mouth scaling (FMS) in improving periodontal, microbiological, and proinflammatory cytokines levels in patients undergoing fixed orthodontics treatment (FOT). Materials and methods: The study recruited 60 teenage patients who were undergoing FOT. All the patients were arbitrarily divided into two groups: Group 1, FMS +PDT and Group 2, FMS alone. Plaque scores (PS), bleeding on probing (BOP), and probing depth (PD) were assessed. Levels of biomarkers interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-α) using enzyme-linked immunosorbent assay were evaluated. Samples were collected from gingival plaque for estimation of Prevotella intermedia and Porphyromonas gingivalis load. All measurements were completed at three intervals baseline, 4th week, and 8th week. Post Hoc corrections and intergroup comparisons were examined using Student's t-test and Bonferroni correction. To find differences between repeated follow-ups, analysis of variance (ANOVA) multiple rank tests were used. Results: At baseline, all the gingival parameters displayed comparable outcomes between patients of Group 1 and Group 2 (p > 0.05). However, at 4 and 8 weeks of follow-up, PS and BOP among tested groups exhibited significantly lower values than baseline (p < 0.001). At 8 weeks, there was a significant difference in PS between the two groups tested. Moreover, at 4 and 8 weeks, BOP revealed a significant difference between the groups. PD remains comparable with baseline at follow-up visits (p > 0.05). A significant decrease in IL-6 and TNF-α levels was observed in both investigated groups at 4 and 8 weeks of baseline. Moreover, it was identified that P. intermedia and P. gingivalis were reduced significantly at 4 weeks. Moreover, a significant difference existed between both Group 1 and Group 2 at 4 and 8 weeks of recall visit (p < 0.05). Conclusions: The use of photodynamic treatment adjuvant to FMS aids in improving periodontal parameters and cytokines levels.
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Affiliation(s)
- Ali Alqerban
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Saeed N Asiri
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Rawda Alghabban
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Fahad Alharbi
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Abdullah Almalki
- Department of Preventive Dental Sciences, College of Dentistry, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Ali S Aljhani
- Department of Dentistry, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Nations Guard Hospital, Riyadh, Saudi Arabia
| | - Ferdous Bukhary
- Department of Preventive Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Rawa Abdelrahim
- Department of Preventive Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Fahad Alkhtani
- Department of Prosthodontics, College of Dentistry, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Abdulaziz Samran
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia
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15
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Skalerič E, Petelin M, Gašpirc B. Antimicrobial photodynamic therapy in treatment of aggressive periodontitis (stage III, grade C periodontitis): A comparison between photodynamic therapy and antibiotic therapy as an adjunct to non-surgical periodontal treatment. Photodiagnosis Photodyn Ther 2022; 41:103251. [PMID: 36587861 DOI: 10.1016/j.pdpdt.2022.103251] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 12/17/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Treatment of aggressive periodontitis (stage III, grade C periodontitis) represents a challenge. The aim of the study was to compare the long-term results of antimicrobial photodynamic therapy (aPDT) and antibiotic therapy as an adjunct to conventional non-surgical therapy in patients with aggressive periodontitis. MATERIALS AND METHODS Twenty subjects with untreated aggressive periodontitis (stage III, grade C periodontitis) were divided into two groups: the test group (TG) received non-surgical therapy and two sessions of aPDT using a laser (HELBO TheraLite laser) with a wavelength of 670 nm associated with HELBO Blue photosensitizer, and the control group (CG) received non-surgical therapy and antibiotics (amoxicillin 500 mg and metronidazole 400 mg, 7 days). Clinical parameters of probing depth, clinical attachment level and bleeding on probing (BOP) were assessed at baseline, 3, 6, 9 and 12 months after treatment. RESULTS The mean probing pocket depths at baseline were 3.68 mm in TG and 3.51 mm in CG. These values decreased to 2.77 mm (p < 0.05) and 2.54 mm (p < 0.05) 3 months after treatment and stayed decreased after 12 months. Clinical attachment levels at baseline were 3.88 mm in TG and 3.70 mm in CG. These values decreased to 3.06 mm (p < 0.05) and 2.80 mm (p < 0.05) after 3 months and stayed decreased after 12 months. We also found a decrease in BOP after 3, 6, 9 and 12 months in TG and in CG. CONCLUSIONS aPDT and antibiotics as an adjunct to non-surgical periodontal treatment lead to a comparable improvement in long term periodontal parameters.
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Affiliation(s)
- Eva Skalerič
- Department of Oral Medicine and Periodontology, Faculty of Medicine and University Medical Center, Ljubljana, Slovenia.
| | - Milan Petelin
- Department of Oral Medicine and Periodontology, Faculty of Medicine and University Medical Center, Ljubljana, Slovenia.
| | - Boris Gašpirc
- Department of Oral Medicine and Periodontology, Faculty of Medicine and University Medical Center, Ljubljana, Slovenia.
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The Efficiency of Photodynamic Therapy in the Bacterial Decontamination of Periodontal Pockets and Its Impact on the Patient. Diagnostics (Basel) 2022; 12:diagnostics12123026. [PMID: 36553035 PMCID: PMC9776409 DOI: 10.3390/diagnostics12123026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
Research in the field of periodontal disease continues to focus on disease-associated microorganisms, as the microbial plaque and the host immune responses are considered to be important causative factors, that are highly responsible for the progression of this disease. The purpose of this article is to compare the reduction in the number of specific periodontopathogens in two test groups according to different therapeutic approaches in periodontal disease and to show possible differences. This article is based on a prospective clinical study involving eighteen subjects with forty-four average periodontal pockets assigned to study groups treated by two different methods, SRP and SRP followed by a single PDT application. Efficiency in removing specific bacterial species was evaluated by PCR testing, at baseline and immediately after treatment. The hypothesis that using SRP + aPDT results in an increased decontamination potential was confirmed statistically, when all five specific bacterial pathogens were investigated together. When the pathogens were considered separately, two of the five microorganisms tested were significantly lower in the SRP + PDT group (p < 0.00), and important germ counts reductions were also observed for the other three. There is also a statistically significant relation between the pain at 48 h postoperatively and the type of treatment the patients received, as resulted from the Questionnaire Form. Our results demonstrate that aPDT, as an adjunctive treatment to conservative mechanical cleaning of root surfaces at sites affected by periodontitis, represents an effective tool in terms of reducing specific periodontopathogen germs.
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Rossi R, Rispoli L, Lopez MA, Netti A, Petrini M, Piattelli A. Photodynamic Therapy by Mean of 5-Aminolevulinic Acid for the Management of Periodontitis and Peri-Implantitis: A Retrospective Analysis of 20 Patients. Antibiotics (Basel) 2022; 11:antibiotics11091267. [PMID: 36140046 PMCID: PMC9495362 DOI: 10.3390/antibiotics11091267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Periodontitis and peri-implantitis are common in the population worldwide. Periodontal diseases affect approximately 50% of adults, while mucositis affects 80% of patients with implants, turning into peri-implantitis at a rate varying from 28 to 58%. If standardized treatments for all degrees and variety of periodontal diseases are known and codified, a consensus on the treatment of peri-implantitis still has to be found. Photodynamic therapy (PDT) has been used successfully in the medical field and was recently introduced as supportive therapy in dentistry. This paper reviews the results on 20 patients, 10 affected by periodontal disease (grades II to III) and 10 by peri-implantitis. Application of 5% 5-aminolevulinic acid gel (ALAD), as a support of causal therapy, in periodontal pockets and areas of peri-implantitis favored the maintenance of severely compromised teeth and significantly improved compromised implant conditions. Between baseline and 6 months, all teeth and implants remained functional. All patients confirmed that the scaling and root planning (SRP)+ALAD-PDT was not painful, and all perceived a benefit after the treatment at all timing points. For periodontal patients, a significant decrease in PPD after 3 (p < 0.001) and 6 months after SRP+ALAD-PDT respect baseline values were observed. For the implant patients, the SRP+ALAD-PDT was correlated to a decrease in PPD and BOP, and a slight increase in the number of exposed threads. However, the results were statistically significant only for PPD (p < 0.001).
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Affiliation(s)
| | - Lorena Rispoli
- Department of Periodontology, Humanitas Dental Center, Humanitas Research Hospital, Rozzano, 20089 Milano, Italy
| | - Michele Antonio Lopez
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica Sacro Cuore, 00168 Rome, Italy
- Correspondence: ; Tel./Fax: +39-06-3015-4079
| | - Andrea Netti
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Morena Petrini
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66013 Chieti, Italy
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy
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Effectiveness of Photobiomodulation Therapy on Human Bone Healing in Dentistry: A Systematic Review. Photobiomodul Photomed Laser Surg 2022; 40:440-453. [DOI: 10.1089/photob.2021.0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cosgarea R, Ramseier CA, Jepsen S, Arweiler NB, Jervøe-Storm PM, Batori-Andronescu I, Rößler R, Conrad T, Eick S, Sculean A. One-Year Clinical, Microbiological and Immunological Results of Local Doxycycline or Antimicrobial Photodynamic Therapy for Recurrent/Persisting Periodontal Pockets: A Randomized Clinical Trial. Antibiotics (Basel) 2022; 11:antibiotics11060738. [PMID: 35740145 PMCID: PMC9220761 DOI: 10.3390/antibiotics11060738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/21/2022] [Accepted: 05/27/2022] [Indexed: 02/04/2023] Open
Abstract
We evaluated, in this study, the clinical, microbiological and immunological effects of local drug delivery (LDD) or photodynamic therapy (PDT), adjunctive to subgingival instrumentation (SI) in persistent or recurrent periodontal pockets in patients enrolled in supportive periodontal therapy (SPT) after one year. A total of 105 patients enrolled in SPT with persistent/recurrent pockets were randomly treated with SI +PDT or SI + LDD or SI (control). The number of treated sites with bleeding on probing (n BOP+), probing pocket depths (PPD), clinical attachment level (CAL), full-mouth plaque and bleeding scores (gingival bleeding index, %bleeding on probing-BOP) was evaluated at baseline and after 12 months. Additionally, eight periodontopathogens and the immunomarkers IL-1β (interleukin)and MMP-8 (matrix metalloprotease) were quantitatively determined using real-time PCR and ELISA, respectively. All three treatments resulted in statistically significant clinical improvements (p < 0.05) without statistically significant intergroup differences (p > 0.05), which were maintained up to 12 months. The presence of BOP negatively affected the PPD and CAL. Moreover, statistically significantly fewer bleeding sites at 12 months were observed in the test groups (p = 0.049). Several periodontopathogens were reduced after 12 months. In conclusion, the present data indicate that in periodontal patients enrolled in SPT, treatment of persistent/recurrent pockets with SI alone or combined with either PDT or LDD may lead to comparable clinical, microbiological and immunological improvements, which are maintained up to 12 months. Secondly, the presence of BOP directly impacts the PPD and CAL.
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Affiliation(s)
- Raluca Cosgarea
- Department for Periodontology, Operative and Preventive Dentistry, University of Bonn, 53111 Bonn, Germany; (S.J.); (P.M.J.-S.)
- Clinic for Periodontology and Peri-Implant Diseases, Philipps University Marburg, 35033 Marburg, Germany;
- Department of Prosthodontics, Iuliu Hatieganu University Cluj-Napoca, 400006 Cluj-Napoca, Romania
- Correspondence: ; Tel.: +49-(0)-228-2872-2480; Fax: +49-(0)-228-2872-2161
| | - Christoph A. Ramseier
- Department of Periodontology, School of Dentistry, University of Bern, 3010 Bern, Switzerland; (C.A.R.); (S.E.); (A.S.)
| | - Søren Jepsen
- Department for Periodontology, Operative and Preventive Dentistry, University of Bonn, 53111 Bonn, Germany; (S.J.); (P.M.J.-S.)
| | - Nicole Birgit Arweiler
- Clinic for Periodontology and Peri-Implant Diseases, Philipps University Marburg, 35033 Marburg, Germany;
| | - Pia Merete Jervøe-Storm
- Department for Periodontology, Operative and Preventive Dentistry, University of Bonn, 53111 Bonn, Germany; (S.J.); (P.M.J.-S.)
| | | | - Ralf Rößler
- University for Digital Technologies in Medicine and Dentistry, 9516 Wiltz, Luxembourg; (R.R.); (T.C.)
| | - Torsten Conrad
- University for Digital Technologies in Medicine and Dentistry, 9516 Wiltz, Luxembourg; (R.R.); (T.C.)
- Clinic for Mouth, Jaw and Plastic Facesurgery, University of Frankfurt, 6059 Frankfurt, Germany
- Private Practice, 55411 Bingen am Rhein, Germany
| | - Sigrun Eick
- Department of Periodontology, School of Dentistry, University of Bern, 3010 Bern, Switzerland; (C.A.R.); (S.E.); (A.S.)
| | - Anton Sculean
- Department of Periodontology, School of Dentistry, University of Bern, 3010 Bern, Switzerland; (C.A.R.); (S.E.); (A.S.)
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20
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Calciolari E, Ercal P, Dourou M, Akcali A, Tagliaferri S, Donos N. The efficacy of adjunctive periodontal therapies during supportive periodontal care in patients with residual pockets. A systematic review and meta-analysis. J Periodontal Res 2022; 57:671-689. [PMID: 35579234 DOI: 10.1111/jre.13001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/18/2022] [Accepted: 04/29/2022] [Indexed: 11/29/2022]
Abstract
While it is well-established that patients that develop signs of relapsing periodontitis in supportive periodontal care (SPC) will need to repeat subgingival instrumentation of the residual pockets, less certainty is available in terms of which protocol should be followed and whether the use of adjunctive therapies or physical agents might provide additional benefits to repeated instrumentation alone. The aim of this systematic review was therefore to assess whether repeating subgingival instrumentation in combination with adjunctive therapies (other than antimicrobials) might provide a significant benefit in terms of pocket closure, probing pocket depth (PPD) reduction or clinical attachment level (CAL) gain in patients during SPC with residual/relapsing pockets. Four databases were searched to identify randomized controlled trials (RCTs) and controlled clinical trials (CCTs) with a minimum follow-up of 3 months that investigated the use of adjunctive therapies (other than antimicrobials) in case of residual/relapsing pockets in patients in SPC since at least 3 months. Data extraction and risk of bias assessment were performed in the studies meeting the inclusion criteria and meta-analysis was performed when ≥3 studies assessing the same adjunctive therapy were identified. 12 studies (2 CCTs and 10 RCTs) were included for qualitative analysis. Meta-analysis was performed only for 3 studies on the adjunctive use of photodynamic therapy (PDT) and it indicated a nonsignificant benefit compared to the placebo in terms of PPD reduction and CAL gain at 3 months (weighted mean difference 0.07 and -0.03, respectively) and at 6 months of follow-up (weighted mean difference -0.09 and -0.18, respectively). While antiseptics did not provide significant benefits, one study on probiotics and one on the use of vitamin D and calcium supplementation showed significant improvements in periodontal parameters. There is currently insufficient/poor evidence to determine the efficacy of adjunctive strategies (other than antimicrobials) to improve the outcomes of SPC in case of residual/relapsing pockets.
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Affiliation(s)
- Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Dental School, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Pinar Ercal
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Marina Dourou
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Aliye Akcali
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Department of Periodontology, Faculty of Dentistry, Dokuz Eylul University, Izmir, Turkey
| | - Sara Tagliaferri
- Department of Medicine and Surgery, University of Parma, Parma, Italy.,Centre for Research in Toxicology (CERT), University of Parma, Parma, Italy
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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21
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Randomized and Controlled Clinical Studies on Antibacterial Photodynamic Therapy: An Overview. PHOTONICS 2022. [DOI: 10.3390/photonics9050340] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The emergence of drug-resistant bacteria is considered a critical public health problem. The need to establish alternative approaches to countering resistant microorganisms is unquestionable in overcoming this problem. Among emerging alternatives, antimicrobial photodynamic therapy (aPDT) has become promising to control infectious diseases. aPDT is based on the activation of a photosensitizer (PS) by a particular wavelength of light followed by generation of the reactive oxygen. These interactions result in the production of reactive oxygen species, which are lethal to bacteria. Several types of research have shown that aPDT has been successfully studied in in vitro, in vivo, and randomized clinical trials (RCT). Considering the lack of reviews of RCTs studies with aPDT applied in bacteria in the literature, we performed a systematic review of aPDT randomized clinical trials for the treatment of bacteria-related diseases. According to the literature published from 2008 to 2022, the RCT study of aPDT was mostly performed for periodontal disease, followed by halitosis, dental infection, peri-implantitis, oral decontamination, and skin ulcers. A variety of PSs, light sources, and protocols were efficiently used, and the treatment did not cause any side effects for the individuals.
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22
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Strazzi-Sahyon HB, Cintra LTA, Nakao JM, Takamiya AS, Queiroz ÍODA, Henrique Dos Santos P, de Oliveira SHP, Sivieri-Araujo G. Cytotoxicity of root canal irrigating solutions and photodynamic therapy using curcumin photosensitizer. Photodiagnosis Photodyn Ther 2022; 38:102795. [PMID: 35263668 DOI: 10.1016/j.pdpdt.2022.102795] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/20/2022] [Accepted: 03/02/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) has shown satisfactory antibacterial effects. However, few information regarding the cytotoxicity potential of PDT using curcumin as a photosensitizer (PS) on fibroblasts are found. The aim of this in vitro study was to evaluate the cytotoxicity of root canal irrigating solutions and photodynamic therapy with curcumin PS on the L-929 cell line. METHODS Healthy mouse skin fibroblast cells were distributed into the following 7 experimental groups: G1 - culture medium DMEM (control group); G2 - 0.9% sodium chloride; G3 - 2.5% sodium hypochlorite (NaOCl); G4 - 5% NaOCl; G5 - PDT with curcumin PS at 500 mg/L + blue LED; G6 - PDT with curcumin PS at 750 mg/L + blue LED; and G7 - PDT with curcumin PS at 1000 mg/L + blue LED. All experimental groups which underwent PDT action were submitted to blue LED for 4 minutes, with a wavelength of 480 nm and energy fluency of 75 J/cm². The cultures were maintained under standard cell culture conditions (37°C, 100% humidity, 5% CO2). Cell viability analysis was performed using the colorimetric method to evaluate the periods of 6, 24, and 48 hours. Data were subjected to the Kruskal-Wallis test, followed by the Dunn test to compare groups and Friedman test to compare periods (α = 0.05). RESULTS When comparing the periods, no significant differences were observed for any of the experimental groups analyzed (p > 0.05), except for the NaOCl2.5 group that exhibited higher cell viability at 6 hours compared to the period of 48 hours (p = 0.0489). In the comparisons of the experimental groups, there were no statistically significant differences between the control group compared to all disinfection protocols, regardless of the period evaluated (p > 0.05), except for the PDT + C1000 group that showed lower cell viability (p < 0.05). CONCLUSIONS PDT with curcumin at 1000 mg/L was cytotoxic on L-929 fibroblast cell culture. However, laser-activated curcumin at a concentration of 500 mg/L presented no influence on L-929 fibroblast cell viability in in vitro conditions.
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Affiliation(s)
- Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
| | - Jaqueline Midori Nakao
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
| | - Aline Satie Takamiya
- Department of Surgery and Integrated Clinic, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
| | - Índia Olinta de Azevedo Queiroz
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
| | - Paulo Henrique Dos Santos
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
| | | | - Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
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23
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Abdulkareem A, Abdulbaqi H, Gul S, Milward M, Chasib N, Alhashimi R. Classic vs. Novel Antibacterial Approaches for Eradicating Dental Biofilm as Adjunct to Periodontal Debridement: An Evidence-Based Overview. Antibiotics (Basel) 2021; 11:antibiotics11010009. [PMID: 35052887 PMCID: PMC8773342 DOI: 10.3390/antibiotics11010009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/10/2021] [Accepted: 12/20/2021] [Indexed: 12/14/2022] Open
Abstract
Periodontitis is a multifactorial chronic inflammatory disease that affects tooth-supporting soft/hard tissues of the dentition. The dental plaque biofilm is considered as a primary etiological factor in susceptible patients; however, other factors contribute to progression, such as diabetes and smoking. Current management utilizes mechanical biofilm removal as the gold standard of treatment. Antibacterial agents might be indicated in certain conditions as an adjunct to this mechanical approach. However, in view of the growing concern about bacterial resistance, alternative approaches have been investigated. Currently, a range of antimicrobial agents and protocols have been used in clinical management, but these remain largely non-validated. This review aimed to evaluate the efficacy of adjunctive antibiotic use in periodontal management and to compare them to recently suggested alternatives. Evidence from in vitro, observational and clinical trial studies suggests efficacy in the use of adjunctive antimicrobials in patients with grade C periodontitis of young age or where the associated risk factors are inconsistent with the amount of bone loss present. Meanwhile, alternative approaches such as photodynamic therapy, bacteriophage therapy and probiotics showed limited supportive evidence, and more studies are warranted to validate their efficiency.
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Affiliation(s)
- Ali Abdulkareem
- College of Dentistry, University of Baghdad, Medical City of Baghdad, Baghdad 10011, Iraq; (H.A.); (N.C.); (R.A.)
- Correspondence:
| | - Hayder Abdulbaqi
- College of Dentistry, University of Baghdad, Medical City of Baghdad, Baghdad 10011, Iraq; (H.A.); (N.C.); (R.A.)
| | - Sarhang Gul
- College of Dentistry, University of Sulaimani, Sulaymaniyah 40062, Iraq;
| | - Mike Milward
- College of Dentistry, University of Birmingham, Birmingham B5 7EG, UK;
| | - Nibras Chasib
- College of Dentistry, University of Baghdad, Medical City of Baghdad, Baghdad 10011, Iraq; (H.A.); (N.C.); (R.A.)
| | - Raghad Alhashimi
- College of Dentistry, University of Baghdad, Medical City of Baghdad, Baghdad 10011, Iraq; (H.A.); (N.C.); (R.A.)
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24
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Besegato JF, de Melo PBG, Tamae PE, Alves APAR, Rondón LF, Leanse LG, Dos Anjos C, Casarin HH, Chinelatti MA, Faria G, Dai T, Bagnato VS, Rastelli ANDS. How can biophotonics help dentistry to avoid or minimize cross infection by SARS-CoV-2? Photodiagnosis Photodyn Ther 2021; 37:102682. [PMID: 34910994 PMCID: PMC8666148 DOI: 10.1016/j.pdpdt.2021.102682] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 09/30/2021] [Accepted: 12/10/2021] [Indexed: 12/23/2022]
Abstract
Biophotonics is defined as the combination of biology and photonics (the physical science of the light). It is a general term for all techniques that deal with the interaction between biological tissues/cells and photons (light). Biophotonics offers a great variety of techniques that can facilitate the early detection of diseases and promote innovative theragnostic approaches. As the COVID-19 infection can be transmitted due to the face-to-face communication, droplets and aerosol inhalation and the exposure to saliva, blood, and other body fluids, as well as the handling of sharp instruments, dental practices are at increased risk of infection. In this paper, a literature review was performed to explore the application of Biophotonics approaches in Dentistry focusing on the COVID-19 pandemic and how they can contribute to avoid or minimize the risks of infection in a dental setting. For this, search-related papers were retrieved from PubMED, Scielo, Google Schoolar, and American Dental Association and Centers for Disease Control and Prevention databases. The body of evidence currently available showed that Biophotonics approaches can reduce microorganism load, decontaminate surfaces, air, tissues, and minimize the generation of aerosol and virus spreading by minimally invasive, time-saving, and alternative techniques in general. However, each clinical situation must be individually evaluated regarding the benefits and drawbacks of these approaches, but always pursuing less-invasive and less aerosol-generating procedures, especially during the COVID-19 pandemic.
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Affiliation(s)
- João Felipe Besegato
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Priscila Borges Gobbo de Melo
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Patrícia Eriko Tamae
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Ana Paula Aparecida Raimundo Alves
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Luis Felipe Rondón
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Leon G Leanse
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | - Carolina Dos Anjos
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | - Heitor Hussni Casarin
- Dentistry School, Central Paulista University Center - UNICEP, São Carlos 13563-470, SP, Brazil
| | | | - Gisele Faria
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil.
| | - Tianhong Dai
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | | | - Alessandra Nara de Souza Rastelli
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil.
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25
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Kharkar VV, Kolte AP, Kolte RA, Bawankar PV, Lathiya VN, Bodhare GH. Influence of Adjunctive Photodynamic Therapy on Interleukin-6, Interleukin-8, and Interleukin-10 Gingival Crevicular Fluid Levels in Chronic Periodontitis - A Randomized Controlled Trial. Contemp Clin Dent 2021; 12:235-240. [PMID: 34759679 PMCID: PMC8525821 DOI: 10.4103/ccd.ccd_510_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 07/18/2020] [Accepted: 08/04/2020] [Indexed: 11/05/2022] Open
Abstract
Background: Numerous studies have assessed the effect of photodynamic therapy (PDT) both as a primary mode of treatment and as an adjunct to scaling and root planing in the treatment of periodontitis. Some results were nondefinitive and, in part, inconsistent with respect to the clinical and biochemical effects. Hence, the aim of this study was to evaluate the effect of PDT as an adjunct to nonsurgical periodontal therapy (NSPT) on the gingival crevicular fluid (GCF) interleukin-6 (IL-6), IL-8, and IL-10 levels in the treatment of chronic periodontitis (CP). Materials and Methods: In 21 patients with CP, two contralateral sites (premolar and molar) were randomly divided into: control sites (treated with NSPT only) and test sites (treated with NSPT + PDT). Clinical parameters including bleeding on probing (BOP), probing pocket depth, clinical attachment level were evaluated at baseline, 1- and 3 months and biochemical parameters of GCF levels of IL-6, IL-8, and IL-10 were evaluated at baseline and 3-month post-therapy through enzyme-linked immunosorbant assay. Results: A greater improvement in BOP score at 1 month (41.10% ± 3.58%) and 3-months (38.00% ± 3.62%) posttherapy was found in the test site as compared to control site. Regarding cytokines, test sites exhibited significant reductions in IL-6 (4.29 ± 0.67 pg/ml) and IL-8 (308.16 ± 36.04 pg/ml) levels and increase in IL-10 (14.25 ± 0.83 pg/ml) level at 3 months (P < 0.0001). Conclusion: Additional application of PDT, adjunctive to NSPT, resulted in a significant reduction in BOP score as well as GCF pro-inflammatory cytokine levels along with an increase in anti-inflammatory cytokine levels, compared to NSPT alone.
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Affiliation(s)
- Vishakha Vilas Kharkar
- Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Abhay Pandurang Kolte
- Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Rajashri Abhay Kolte
- Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Pranjali Vijaykumar Bawankar
- Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Vrushali Nilesh Lathiya
- Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Girish Haripal Bodhare
- Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
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26
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Bashir NZ, Singh HA, Virdee SS. Indocyanine green-mediated antimicrobial photodynamic therapy as an adjunct to periodontal therapy: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:5699-5710. [PMID: 33710461 PMCID: PMC8443506 DOI: 10.1007/s00784-021-03871-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/03/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis was to evaluate the efficacy of indocyanine green-mediated photodynamic therapy (ICG-PDT) as an adjunct to non-surgical periodontal therapy (NSPT), in the management of chronic periodontitis. MATERIALS AND METHODS Four electronic databases (PubMed, Cochrane Central Register of Controlled Trials, Embase via OVID, Web of Science) were searched for randomised controlled trials comparing NSPT with ICG-PDT to NSPT without laser therapy. Primary outcome measures were changes in probing pocket depth (PPD) and clinical attachment level (CAL). Clinical outcomes were extracted and pooled from 7 eligible trials and meta-analyses conducted using mean difference with standard deviations. RESULTS For PPD, adjunctive ICG-PDT resulted in a mean additional reduction of 1.17 mm (95% CI: 0.67-1.66 mm) at 3 months and a mean additional reduction of 1.06 mm (95% CI: 0.54-1.57 mm) at 6 months. For CAL, adjunctive ICG-PDT resulted in a mean additional gain of 0.70 mm (95% CI: 0.17-1.23 mm) at 3 months and a mean additional gain of 1.03 mm (95% CI: 0.83-1.24 mm) at 6 months. No adverse events were reported in any studies. CONCLUSIONS The adjunctive use of ICG-PDT in NSPT results in improved treatment outcomes at 3 and 6 months post-therapy. Further investigation is needed to evaluate variables such as different photosensitiser concentrations and adjusting parameters associated with the light source. CLINICAL RELEVANCE Indocyanine green-based photosensitisers may be a novel, clinically efficacious agent for use in the management of periodontitis.
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Affiliation(s)
- Nasir Zeeshan Bashir
- School of Dentistry, University of Birmingham, Edgbaston, Birmingham, B5 7SA, UK.
| | - Har-Amrit Singh
- School of Dentistry, University of Birmingham, Edgbaston, Birmingham, B5 7SA, UK
| | - Satnam Singh Virdee
- School of Dentistry, University of Birmingham, Edgbaston, Birmingham, B5 7SA, UK
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27
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Cláudio MM, Nuernberg MAA, Rodrigues JVS, Belizário LCG, Batista JA, Duque C, Garcia VG, Theodoro LH. Effects of multiple sessions of antimicrobial photodynamic therapy (aPDT) in the treatment of periodontitis in patients with uncompensated type 2 diabetes: A randomized controlled clinical study. Photodiagnosis Photodyn Ther 2021; 35:102451. [PMID: 34303029 DOI: 10.1016/j.pdpdt.2021.102451] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND The aim of this study was to compare, through clinical and microbiological analysis, the use of multiple applications of aPDT as an adjuvant therapy to non-surgical periodontal treatment of stage III and IV grade C periodontitis in type 2 diabetic (DM2) patients. METHODS Thirty-four patients with non-compensated DM2 and periodontitis were randomly divided into two groups: SRP Group (n = 17): scaling and root planing (SRP); and SRP+aPDT Group (n = 17): SRP followed by 3 consecutive aPDT applications, immediately, 48 and 96 h after in pockets with probing depth (PD) ≥5 mm. In SRP+aPDT, after 1 min of irrigation with methylene blue (10 mg/ml), the sites were irradiated with a 660 nm diode laser for 50 s (157 J/cm2, 4.7 J, 100 mW). Porphyromonas gingivalis (P. gingivalis) and Prevotella intermedia (P. intermedia) were quantified by real-time qPCR. Periodontal clinical and microbiological data (baseline, 90 and 180 days) were statistically analyzed (α = 5%). RESULTS There was a significant reduction in PD and bleeding on probing at 90 and 180 days post-treatment in both groups (p<0.05). The SRP+aPDT group presented a significant reduction in the number of residual pockets at 90 and 180 days (p<0.05). The SRP+aPDT group presented reduced PD means in deep pockets 180 days post-treatment (p<0.05). No differences were observed in P. gingivalis and P. intermedia levels (p>0.05). CONCLUSION The results of present study indicate that the use of multiples aPDT sessions as adjuvant therapy in the periodontal treatment of uncompensated diabetic patients with periodontitis promotes additional clinical benefits.
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Affiliation(s)
- Marina Módolo Cláudio
- Department of Diagnostic and Surgery, Periodontics Division, São Paulo State University - UNESP, Dentistry School of Araçatuba, Araçatuba, SP, Brazil
| | - Marta Aparecida Alberton Nuernberg
- Department of Diagnostic and Surgery, Periodontics Division, São Paulo State University - UNESP, Dentistry School of Araçatuba, Araçatuba, SP, Brazil
| | - João Victor Soares Rodrigues
- Department of Diagnostic and Surgery, Periodontics Division, São Paulo State University - UNESP, Dentistry School of Araçatuba, Araçatuba, SP, Brazil
| | - Lícia Clara Garcia Belizário
- Department of Diagnostic and Surgery, Periodontics Division, São Paulo State University - UNESP, Dentistry School of Araçatuba, Araçatuba, SP, Brazil
| | - Júlia Arruda Batista
- Department of Diagnostic and Surgery, Periodontics Division, São Paulo State University - UNESP, Dentistry School of Araçatuba, Araçatuba, SP, Brazil
| | - Cristiane Duque
- Department of Preventive and Restorative Dentistry, São Paulo State University - UNESP, Dentistry School of Araçatuba, Araçatuba, SP, Brazil
| | - Valdir Gouveia Garcia
- Latin American Institute of Dental Research and Teaching (ILAPEO), Curitiba, PR, Brazil
| | - Letícia Helena Theodoro
- Department of Diagnostic and Surgery, Periodontics Division, São Paulo State University - UNESP, Dentistry School of Araçatuba, Araçatuba, SP, Brazil.
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Clinical efficacy of single and multiple applications of antimicrobial photodynamic therapy in periodontal maintenance: A systematic review and network meta-analysis. Photodiagnosis Photodyn Ther 2021; 36:102435. [PMID: 34245916 DOI: 10.1016/j.pdpdt.2021.102435] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND At present the clinical efficacy of single (S) versus multiple (M) applications of antimicrobial photodynamic therapy (aPDT) is controversially discussed. AIM To systematically evaluate the clinical efficacy of adjunctive S and M applications of aPDT to subgingival debridement (SD) in the treatment of residual periodontal pockets. METHODS An electronic search was carried out for randomized controlled clinical trials (RCTs) reporting on SD with the adjunctive use of S- or M-aPDT applications. RESULTS Statistically significantly higher improvement in bleeding on probing (BOP) and probing depth (PD) reduction was found for SD + S-aPDT versus SD, with Mean difference (MD) = -16.8 (95% CI: -30.7 to -2.91; p = 0.02) and 0.4, (95% CI: 0.02 to 0.78, p = 0.04), respectively. Regarding BOP, there was also a statistically significant difference when SD + M-aPDT was compared with SD alone, with a MD of -5.13 (95% CI: -7.20 to -3.07; p < 0.00001). For all parameters, SD + S-aPDT demonstrated the best treatment ranking of probability results, followed by SD + M-aPDT and SD alone. CONCLUSIONS Within their limits, the present data indicate that in periodontal patients enrolled in maintenance: a) single and multiple adjunctive applications of aPDT following SD resulted in statistically significant BOP reduction compared to SD alone, and b) repeated applications of aPDT did not seem to result in superior outcomes compared to single applications.
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Trombelli L, Farina R, Pollard A, Claydon N, Franceschetti G, Khan I, West N. Efficacy of alternative or additional methods to professional mechanical plaque removal during supportive periodontal therapy: A systematic review and meta-analysis. J Clin Periodontol 2021; 47 Suppl 22:144-154. [PMID: 32060940 DOI: 10.1111/jcpe.13269] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 01/20/2020] [Accepted: 02/10/2020] [Indexed: 12/18/2022]
Abstract
AIMS To systematically review the literature addressing the following focused questions: "What is the efficacy of either (#1) alternative or (#2) additional methods to professional mechanical plaque removal (PMPR) on progression of attachment loss during supportive periodontal therapy (SPT) in periodontitis patients?". METHODS A systematic search for randomized clinical trials was performed. Change in clinical attachment level (CAL) from baseline was the primary outcome. RESULTS Routine PMPR performed with either a combination of ultrasonic/hand instruments or Er:Yag laser showed similarly effective in preventing CAL loss. Moreover, a routine SPT regimen based on PMPR led to stability of CAL irrespective of a daily sub-antimicrobial doxycycline dose (SDD). Finally, an adjunctive photodynamic therapy (PDT) did not enhance the magnitude of CAL gain when sites with probing depth ≥4 mm were repeatedly treated. After pooling all data, the results of the meta-analysis showed no statistical differences in CAL change from baseline: mean overall CAL change was -0.233 mm (95% confidence interval: -1.065, 0.598; p = .351). CONCLUSIONS Weak evidence indicate that in treated periodontitis patients enrolled in a 3-4 month SPT based on PMPR, Er:Yag laser (as alternative), SDD and PDT (as additional) do not produce a greater clinical effect on periodontal conditions compared to PMPR.
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Affiliation(s)
- Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (AUSL), Ferrara, Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, Azienda Unità Sanitaria Locale (AUSL), Ferrara, Italy
| | - Alexander Pollard
- Periodontology, Clinical Trials Unit, Bristol Dental School, Bristol, UK
| | - Nicholas Claydon
- Periodontology, Clinical Trials Unit, Bristol Dental School, Bristol, UK
| | - Giovanni Franceschetti
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
| | - Iftekhar Khan
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Nicola West
- Periodontology, Clinical Trials Unit, Bristol Dental School, Bristol, UK
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Clinical and Microbiological Evaluation of Local Doxycycline and Antimicrobial Photodynamic Therapy during Supportive Periodontal Therapy: A Randomized Clinical Trial. Antibiotics (Basel) 2021; 10:antibiotics10030277. [PMID: 33803281 PMCID: PMC8001251 DOI: 10.3390/antibiotics10030277] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 01/06/2023] Open
Abstract
The aim of this study was to evaluate the clinical and microbiological effects of subgingival instrumentation (SI) alone or combined with either local drug delivery (LDD) or photodynamic therapy (PDT) in persistent/recurrent pockets in patients enrolled in supportive periodontal therapy (SPT). A total of 105 patients enrolled in SPT were randomly treated as follows: group A (n = 35): SI +PDT and 7 days later 2nd PDT; group B (n = 35): SI+LDD; group C (n = 35): SI (control). Prior intervention, at 3 and 6 months after therapy, probing pocket depths, clinical attachment level, number of treated sites with bleeding on probing (n BOP), full mouth plaque and bleeding scores (gingival bleeding index, %BOP) were recorded. At the same time points, 8 periodontopathogens were quantitatively determined. All three treatments resulted in statistically significant improvements (p < 0.05) of all clinical parameters without statistically significant intergroup differences (p > 0.05). Several bacterial species were reduced in both test groups, with statistically significantly higher reductions for LDD compared to PDT and the control group. In conclusion, the present data indicate that: (a) In periodontal patients enrolled in SPT, treatment of persistent/recurrent pockets with SI alone or combined with either PDT or LDD may lead to comparable clinical improvements and (b) the adjunctive use of LDD appears to provide better microbiological improvements for some periodontal pathogens than SI alone or combined with PDT.
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Patyna M, Ehlers V, Bahlmann B, Kasaj A. Effects of adjunctive light-activated disinfection and probiotics on clinical and microbiological parameters in periodontal treatment: a randomized, controlled, clinical pilot study. Clin Oral Investig 2021; 25:3967-3975. [PMID: 33543381 PMCID: PMC8137479 DOI: 10.1007/s00784-020-03727-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 12/02/2020] [Indexed: 12/27/2022]
Abstract
Objectives The aim of this pilot study was to evaluate the clinical and microbiological outcomes of light-activated disinfection (LAD) alone or combined with probiotics as an adjunct to non-surgical periodontal treatment. Materials and methods In this single-blinded, randomized, controlled clinical pilot study, 48 patients (28 females and 20 males) with untreated periodontitis (stages II and III, grade B) were included. Using a parallel-group design, patients were randomly assigned into 3 groups to receive subgingival debridement (SD) alone (group 1, n = 16), SD with LAD (group 2, n = 16), or SD with LAD plus probiotic treatment (group 3, n = 16). Probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), gingiva-index simplified (GIs), plaque-control record (PCR), and subgingival microbiological samples were analyzed at baseline, 3 months, and 6 months of follow-up. Results All treatment modalities demonstrated clinical improvements in PPD and CAL at 6 months compared to baseline but without a statistical significant difference between the groups. The combination of SD + LAD + probiotic treatment (group 3) demonstrated significantly greater reductions in BOP, GIs, and red complex bacteria P. gingivalis and T. forsythia compared with other groups at 6 months (p < 0.05). Conclusions A single application of LAD as an adjunct to SD provided no additional clinical and microbiological benefits compared to SD alone. The combination of SD + LAD + probiotic treatment in group 3 led to further improvements of the inflammatory parameters. Clinical relevance The additional use of probiotics in periodontal treatment can be a useful approach to support inflammation and infection control of periodontal tissues. Further studies are necessary to determine the extent of added benefit for this treatment approach.
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Affiliation(s)
- Michael Patyna
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Vicky Ehlers
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Benjamin Bahlmann
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Adrian Kasaj
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany.
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Mallineni S, Nagarakanti S, Gunupati S, Bv RR, Shaik MV, Chava VK. Clinical and microbiological effects of adjunctive photodynamic diode laser therapy in the treatment of chronic periodontitis: A randomized clinical trial. J Dent Res Dent Clin Dent Prospects 2021; 14:191-197. [PMID: 33408826 PMCID: PMC7770395 DOI: 10.34172/joddd.2020.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 02/08/2020] [Indexed: 11/18/2022] Open
Abstract
Background. Conventional mechanical debridement alone cannot eliminate bacteria and their products from periodontal pockets. Adjunctive therapies improve tissue healing through detoxification and bactericidal effects. Photodynamic therapy (PDT) is a non-invasive treatment procedure that involves the use of a dye as a photosensitizer to attach to the target cell and be activated by a photon of an appropriate wavelength. This study aimed to assess the effectiveness of PDT in treating periodontitis as an adjunct to scaling and root planing.
Methods. Fifteen subjects with chronic periodontitis were treated randomly with scaling and root planing (SRP), followed by a single PDT (test) or SRP (control) episode alone. Full-mouth plaque index (PI), sulcus bleeding index (SBI), probing depth (PD), and clinical attachment level (CAL) were assessed at baseline and 1-month and 3-month intervals. Microbiological evaluation of Porphyromonas gingivalis (Pg) in subgingival plaque samples was performed using a commercially available real-time polymerase chain reaction.
Results. The results revealed a significant difference in PI, SBI, PD, CAL, and microbiological parameters between the groups one and three months after treatment.
Conclusion. A combination of PDT and SRP gave rise to a significant improvement in clinical and microbiological parameters in patients with chronic periodontitis.
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Affiliation(s)
- Sahana Mallineni
- Department of Periodontology, Narayana Dental College & Hospital, Nellore, India
| | | | - Sumanth Gunupati
- Department of Periodontology, Narayana Dental College & Hospital, Nellore, India
| | - Ramesh Reddy Bv
- Department of Periodontology, Narayana Dental College & Hospital, Nellore, India
| | - Mahaboob V Shaik
- Department of Genetics, Advanced Research Centre, Narayana Medical College & Hospital, Nellore, India
| | - Vijay K Chava
- Department of Periodontology, Narayana Dental College & Hospital, Nellore, India
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Adjunctive air-polishing with erythritol in nonsurgical periodontal therapy: a randomized clinical trial. BMC Oral Health 2020; 20:364. [PMID: 33372602 PMCID: PMC7771063 DOI: 10.1186/s12903-020-01363-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/10/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. METHODS Fourty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n = 21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n = 21). They were analyzed for the clinical variables BOP (primary outcome at six months), probing depth (PD), attachment level, four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. RESULTS In both groups, the clinical variables PD, attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5 mm was significantly lower in the test group than in the control group after six months. At six months versus baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. CONCLUSIONS Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5 mm when compared with subgingival instrumentation only. CLINICAL RELEVANCE The adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery. Trial registration The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL .
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In vivo investigation of diode laser application on red complex bacteria in non-surgical periodontal therapy: a split-mouth randomised control trial. Sci Rep 2020; 10:21311. [PMID: 33277607 PMCID: PMC7718262 DOI: 10.1038/s41598-020-78435-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/25/2020] [Indexed: 12/14/2022] Open
Abstract
Assessment of the efficacy of a single 810 nm diode laser application as an adjunctive treatment modality during the first intervention of non-surgical periodontal therapy (NPT). 25 patients diagnosed with chronic periodontitis underwent a split-mouth randomised control trial. The periodontal pockets of the test quadrants were treated with an 810 nm diode laser as an adjunct to NPT (Picasso GaAlAs; AMD Lasers). The laser was set at 1.0 W continuous wave, 400 µm tip, 796 W/cm2 peak power density and a 32 J/cm2 energy density. Therapeutic outcomes were evaluated based on the clinical parameters, which included probing pocket depth, recession, clinical attachment level, full mouth plaque score, full mouth bleeding on probing and tooth mobility. The baseline bacterial collection was completed from the periodontal pockets and then re-evaluated at 6 weeks. Clinical parameters demonstrated no statistical difference, with the exception of a statistically significant (P < 0.05) reduction in bleeding on probing for the test side. The test side resulted in a statistical increase of Capnocytophagaspecies and Treponemadenticola. The single application of the diode laser did not significantly improve the bacterial nor the clinical parameters in patients with chronic periodontitis. Trial registration number: PACTR201909915338276.
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Fraga RS, Antunes LAA, Fialho WLS, Valente MI, Gomes CC, Fontes KBFC, Antunes LS. Do Antimicrobial Photodynamic Therapy and Low-Level Laser Therapy Minimize Postoperative Pain and Edema After Molar Extraction? J Oral Maxillofac Surg 2020; 78:2155.e1-2155.e10. [DOI: 10.1016/j.joms.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 12/28/2022]
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Tan OL, Safii SH, Razali M. Clinical Efficacy of Single Application Local Drug Delivery and Adjunctive Agents in Nonsurgical Periodontal Therapy: A Systematic Review and Network Meta-Analysis. Pharmaceutics 2020; 12:E1086. [PMID: 33198248 PMCID: PMC7698182 DOI: 10.3390/pharmaceutics12111086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 12/29/2022] Open
Abstract
This review aimed to rank the clinical efficacy of commercially available single-application local drug delivery and adjunctive agents (LDAs) compared with subgingival mechanical debridement (SMD) in nonsurgical periodontal therapy (NSPT). Randomized controlled clinical trials that compared LDAs against SMD alone or with placebo in adults (aged at least 18 years) diagnosed with periodontitis with a minimum of 6 months follow-up were included. A frequentist approach to random-effects network meta-analysis was implemented. The efficacies of the LDAs measured by probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain were reported as mean difference (MD) with 95% confidence intervals (CIs). The treatments were ranked according to their P-score. Four network meta-analyses suggested that sulfonic/sulfuric acid gel (PPD MD -1.13 mm, 95% CI -1.74 to -0.53, P-score 0.91; CAL MD -1.09 mm, 95% CI -1.58 to -0.61, P-score 0.95) and doxycycline hyclate gel (PPD MD -0.90 mm, 95% CI -1.50 to -0.30, P-score 0.93; CAL MD -0.84 mm, 95% CI -1.40 to -0.28, P-score 0.92) were the most effective in reducing PPD and gaining CAL in split-mouth and parallel studies, respectively (moderate certainty of evidence). LDAs have differing efficacies, but they present with possible clinical significance over SMD alone in NSPT.
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Affiliation(s)
- Oi Leng Tan
- Centre for Restorative Dentistry, Unit of Periodontology, Faculty of Dentistry, National University of Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Syarida Hasnur Safii
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Masfueh Razali
- Centre for Restorative Dentistry, Unit of Periodontology, Faculty of Dentistry, National University of Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
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37
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Wang CY, Yang YH, Li H, Lin PY, Su YT, Kuo MYP, Tu YK. Adjunctive local treatments for patients with residual pockets during supportive periodontal care: A systematic review and network meta-analysis. J Clin Periodontol 2020; 47:1496-1510. [PMID: 33010026 DOI: 10.1111/jcpe.13379] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 08/31/2020] [Accepted: 09/22/2020] [Indexed: 11/29/2022]
Abstract
AIM This systematic review and network meta-analysis aimed to evaluate the efficacy of adjunctive locally delivered antimicrobials, compared to subgingival instrumentation alone or plus a placebo, on changes in probing pocket depth (PPD) and clinical attachment level (CAL), in patients with residual pockets during supportive periodontal care. MATERIALS AND METHODS Literature search was performed with electronic databases and by hand until 31 May 2020. Primary outcome was the changes in PPD. The treatment effects between groups were estimated with weighted mean differences (WMD) with 95% confidence intervals (CI) and prediction intervals (PI) by using random-effects network meta-analysis. RESULTS Twenty-two studies were included. Significantly greater PPD reduction was achieved in chlorhexidine chip group (WMD: 0.65 mm, 95% CI: 0.21-1.10) and tetracycline fibre group (WMD: 0.64 mm, 95% CI: 0.20-1.08) over 6-month follow-up. Other adjunctive antimicrobial agents achieved non-significant improvements compared to scaling and root planing alone. All differences between adjunctive therapies were statistically non-significant. Similar findings were observed for CAL gain. CONCLUSION Adjunctive local antimicrobial agents achieved small additional PPD reduction and CAL gain in residual pockets for a follow-up of up to 6 months. Tetracycline fibre and chlorhexidine chip achieved better results than other antimicrobials.
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Affiliation(s)
- Chen-Ying Wang
- School of Dentistry, National Taiwan University, Taipei, Taiwan.,Division of Periodontics, Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Hao Yang
- School of Dentistry, National Taiwan University, Taipei, Taiwan.,Division of Periodontics, Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Hua Li
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ping-Yi Lin
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Yu-Ting Su
- Department of Dentistry, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Mark Yen-Ping Kuo
- School of Dentistry, National Taiwan University, Taipei, Taiwan.,Division of Periodontics, Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Kang Tu
- School of Dentistry, National Taiwan University, Taipei, Taiwan.,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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Transgingival photodynamic therapy (tg-aPDT) adjunctive to subgingival mechanical instrumentation in supportive periodontal therapy. A randomized controlled clinical study. Photodiagnosis Photodyn Ther 2020; 32:101971. [PMID: 32835882 DOI: 10.1016/j.pdpdt.2020.101971] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 08/16/2020] [Accepted: 08/17/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Recent data from preclinical studies and case series suggest that transgingival irradiation with diode lasers may represent a novel modality for antimicrobial photodynamic therapy (aPDT). However, at present, there is lack of data from controlled clinical studies on the use of transgingival antimicrobial photodynamic therapy (tg-aPDT) in the treatment of periodontitis. OBJECTIVE To evaluate the clinical effects of tg-aPDT used in conjunction with nonsurgical mechanical instrumentation during supportive periodontal therapy (SPT). MATERIALS AND METHODS Forty stage II and III periodontitis patients enrolled in SPT were randomly assigned to two groups of equal size. At baseline, study sites had to show sites with pocket probing depth (PPD) of ≥ 5 mm and Bleeding on Probing (BOP). Full mouth and site-specific Plaque-Index scores (PI), BOP, PPD, and Clinical Attachment Level (CAL) were recorded at baseline (BL), three months (3 M), and 6 months (6 M), respectively. The primary outcome variable was the change in the number of sites with BOP. Treatment was performed under local anaesthesia after random allocation to one of the following groups 1) Subgingival scaling and root planing (SRP) + tg-aPDT (test) or 2) SRP alone (control). RESULTS Thirty-nine patients completed the study. Full mouth PI and BOP improved over six month, however without statistically significant difference between the groups. At 6 M, BOP-levels were statistically significantly lower in test sites (25.0 %) compared to the control sites (65.0 %), (p < 0.025). PPD improved in both groups with comparable mean values at 3 M (PPD test: 5.21 ± 0.92 mm; PPD control: 4.45 ± 1.36 mm) and 6 M (PPD test: 5.11 ± 1.10 mm; PPD control: 4.35 ± 1.14 mm). Additionally, CAL slightly improved in both groups with comparable mean values at 3 M (CAL test: 6.79 ± 1.72 mm; CAL control: 5.30 ± 2.43 mm) and 6 M (CAL test: 6.26 ± 1.70 mm; CAL control: 5.50 ± 2.33 mm). CONCLUSIONS Within its limits, the present results appear to indicate that the use of tg-aPDT adjunctive to SRP may represent a new modality for controlling inflammation and further bleeding in residual periodontal pockets.
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Varma SR, AlShayeb M, Narayanan J, Abuhijleh E, Hadi A, Jaber M, Abu Fanas S. Applications of Lasers in Refractory Periodontitis: A Narrative Review. J Int Soc Prev Community Dent 2020; 10:384-393. [PMID: 33042878 PMCID: PMC7523935 DOI: 10.4103/jispcd.jispcd_241_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/15/2020] [Accepted: 05/22/2020] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE The purpose of the study is to evaluate the various lasers in dentistry and to investigate if it can be used for treatment of refractory periodontitis. METHODS The study followed partially the PRISMA guidelines as it is a narrative review. A number of articles were selected from a period of 1980 to 2020 from databases, PubMed, PubMed central, Cochrane and Scopus. Articles related to the effects of lasers on periodontitis both refractory and aggressive were investigated. RESULTS After reviewing the literature, 70 articles were found, related to application of lasers in periodontal diseases. Out of the 70, 11 articles pertained to the effect of laser for the treatment of Refractory and inflammatory periodontitis. 5 articles related to experimental animal models, one pertaining to in-vitro and six studies related to in-vivo in human cohorts. DISCUSSION It was found that lasers if used in controlled parameters by incorporating laser assisted treatment such as Photodynamic therapy and low level laser therapy can be of use as an adjunct therapy for treatment of refractory periodontitis. The use of different wavelengths in the initial and maintenance phase of periodontal disease plays a positive role. The presence of in-vitro and animal model studies is one of the limitation to this study. The available studies have shown marked reduction in inflammation and better clinical and microbiological parameters. The drawback of this study is the limited literature involving laser management for refractory periodontitis in human cohorts. CONCLUSION Different wavelengths of laser and choice of laser assisted periodontal treatment plays an important role in the overall progress and prognosis of periodontal disease activity.
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Affiliation(s)
- Sudhir Rama Varma
- Department of Periodontics, College of Dentistry, Ajman University, Ajman, UAE
| | - Maher AlShayeb
- Department of Oral Surgery, College of Dentistry, Ajman University, Ajman, UAE
| | - Jayaraj Narayanan
- Department of Basic Sciences, University of Science and Technology of Fujairah, Fujairah, UAE
| | - Eyas Abuhijleh
- Department of Orthodontics, University of Science and Technology, Fujairah, UAE
| | - Abdul Hadi
- Department of Restorative Dentistry, University of Science and Technology, Fujairah, UAE
| | - Mohammad Jaber
- Department of Oral Surgery, College of Dentistry, Ajman University, Ajman, UAE
| | - Salim Abu Fanas
- Department of Periodontics, College of Dentistry, Ajman University, Ajman, UAE
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Siddiqui AZ, Vellappally S, Fouad H, Muckarrum SM. Bactericidal and clinical efficacy of photochemotherapy in acute necrotizing ulcerative gingivitis. Photodiagnosis Photodyn Ther 2020; 29:101668. [PMID: 31988023 DOI: 10.1016/j.pdpdt.2020.101668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 01/13/2020] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
Abstract
AIM This study was designed to investigate the clinical and microbiological parameters with photochemotherapy (PCT) against conventional debridement (CD) among patients with necrotizing ulcerative gingivitis (NUG). MATERIALS AND METHODS Patients with a diagnosis of NUG were divided into two groups: 'Group-PCT' that underwent indocyanine green-mediated PCT with adjunctive mechanical debridement, and Group-CD that underwent mechanical debridement with adjunctive 3 % hydrogen peroxide/chlorhexidine rinse. Clinical inflammatory gingival parameters including full-mouth plaque scores (FMPS), bleeding scores (FMBS), and probing depth (PD) were measured. Counts of Treponema microdentium, Fusobacterium nucleatum and Prevotella intermedia were assessed using polymerase chain reaction technique. All assessments were done at baseline, 3 weeks and 6 weeks. RESULTS Twenty-six participants were contacted and agreed to participate in the trial. The mean age of participants in group-PCT was 24.5 years while the mean age of patients in group-CD was 26.7 years. FMPS showed significant but equal reduction in both the groups at 3 weeks and 6 weeks (p < 0.01). The reduction in mean FMBS was higher in the group-PCT at 6 weeks follow-up (p < 0.05). All bacterial levels reduced from baseline to follow-up with both PCT and CD groups (p < 0.05). Group-PCT showed significantly reduced counts of T. microdentium and F. nucleatum at 3 weeks and 6 weeks compared with group-CD (p = 0.024). Equal reduction was shown for P. intermedia between both the groups at 3 and 6 weeks, respectively. CONCLUSION Application of adjunctive photochemotherapy was both clinically and microbiologically effective in the treatment of NUG.
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Affiliation(s)
- Adel Zia Siddiqui
- Dental Materials Department, Baqai Dental College, Baqai Medical University, Karachi, Pakistan.
| | - Sajith Vellappally
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - H Fouad
- Applied Medical Science Department, CC, King Saud University, Riyadh 11433, Saudi Arabia; Biomedical Engineering Department, Faculty of Engineering, Helwan University, Helwan, Egypt
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Siva NTD, Silva DNDA, Azevedo MLDS, Silva Júnior FLD, Almeida ML, Longo JPF, Moraes MD, Gurgel BCDV, de Aquino Martins ARL. The effectiveness of photodynamic therapy as a complementary therapy to mechanical instrumentation on residual periodontal pocket clinical parameters: A clinical split-mouth test. Photodiagnosis Photodyn Ther 2019; 29:101565. [PMID: 31586644 DOI: 10.1016/j.pdpdt.2019.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/25/2019] [Accepted: 09/30/2019] [Indexed: 12/27/2022]
Abstract
The purpose of this study was to evaluate the effectiveness of photodynamic therapy as complementary therapy to mechanical instrumentation on periodontal residual pockets. This longitudinal, prospective, double-blind and controlled split-mouth clinical trial included one hundred and fourteen residual periodontal sites with probing depth ≥ 4 mm and bleeding on probing, which were distributed into two groups: 57 in the test group (SRP + aPDT) - using a low power laser application Therapy XT (DMC Equipamentos Ltda, São Carlos, São Paulo, Brazil) with operational parameters of 660 nm and 110 mW for 15s, and 57 in the control group (SRP). Oral hygiene conditions were evaluated, through the Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI), as well as periodontal clinical outcomes, comprising the Bleeding on Probing (BOP), Probing Depth (PD) and Clinical Attachment Level (CAL) at baseline and after 3 months. Decrease of 17.74% was observed for the VPI after 3 months of follow-up, while the GBI was reduced by 19.91%, thus indicating statistically significant decreases for both parameters (p < 0.001). Decreases in VPI per site, BOP and PD and CAL gain between T0 and T3 in both treatment groups (p < 0.001) were observed, but no statistically significant intergroup differences were found (p > 0.05). Within the parameters used in this study, adjuvant aPDT to SRP did not lead additional benefits regarding the assessed clinical parameters after three months.
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Affiliation(s)
| | | | | | | | | | - João Paulo Figueiró Longo
- Department of Genetics and Morphology, Institute of Biological Sciences, University of Brasília, Brasília, DF, Brazil.
| | - Maiara de Moraes
- Department of Health Sciences, Center for Biological and Health Sciences, Medicine, Rural Federal University of Semi-Árido (UFERSA), Mossoró, Rio Grande do Norte, RN, Brazil.
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Chiang CP, Hsieh O, Tai WC, Chen YJ, Chang PC. Clinical outcomes of adjunctive indocyanine green-diode lasers therapy for treating refractory periodontitis: A randomized controlled trial with in vitro assessment. J Formos Med Assoc 2019; 119:652-659. [PMID: 31543299 DOI: 10.1016/j.jfma.2019.08.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 08/10/2019] [Accepted: 08/20/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND/PURPOSE It is still challengeable to treat periodontal pockets refractory to mechanical debridement. This study is to evaluate the potential of indocyanine green (ICG)-diode laser-based photothermal therapy (PTT) for solving this dilemma. METHODS Bone marrow-derived mesenchymal stem cells (BMSCs) and periodontal ligament cells (PDLCs) were incubated with phosphate-buffered saline, chlorhexidine, or ICG, non-irradiated or irradiated with 810-nm diode lasers, and the cell viability was evaluated. Patients with teeth refractory to mechanical periodontal debridement on different quadrants were recruited. At baseline (T0), all examined teeth received scaling and root planing, and those on the test quadrant (PTT group) received ICG-diode laser treatment. The outcome was evaluated using clinical parameters and cytokines in the gingival crevicular fluids at 4-6 weeks (T1) and 6 months (T2). RESULTS In ICG-treated cultures, the viability of BMSCs and PDLCs was recovered on day 4, and laser irradiation inhibited the metabolic activities of BMSCs. 22 patients with 30 control teeth and 35 PTT-treated teeth were examined. All examined teeth showed modest reductions in probing pocket depth (PPD), clinical attachment loss (CAL), bleeding upon probing (BOP), and plaque score at T1 and T2 and significant reductions in IL-1β and MMP-8 at T2. Compared with controls, BOP was reduced more prominently, IL-1β and MMP-8 were significantly lower, and reductions in PPD and CAL were slightly greater in the PTT group at T1 (0.05-0.19 mm). CONCLUSION ICG-diode laser-based PTT is compatible to periodontium and assists in faster resolution of gingival inflammation in periodontal pockets refractory to mechanical debridement.
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Affiliation(s)
- Chun-Pin Chiang
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Olivia Hsieh
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Wei-Chiu Tai
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Yi-Jane Chen
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Po-Chun Chang
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.
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Husejnagic S, Lettner S, Laky M, Georgopoulos A, Moritz A, Rausch-Fan X. Photoactivated disinfection in periodontal treatment: A randomized controlled clinical split-mouth trial. J Periodontol 2019; 90:1260-1269. [PMID: 31301146 DOI: 10.1002/jper.18-0576] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 03/18/2019] [Accepted: 04/02/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Photoactivated disinfection (PAD) could support the periodontal treatment outcome. The effect of the light emitting diode (LED) as an innovative light source in PAD is under discussion. The aim of this study was to evaluate the clinical and microbiological effect of adjunctive PAD in the treatment of periodontitis with a red LED as light source. METHODS Twenty patients with periodontitis completed this split-mouth study. The left and right side of the jaws were randomly assigned to either test or control group. After conservative periodontal treatment in both groups, the test group received two sessions of adjunctive PAD (red LED, 635 nm, photosensitive dye, 0.01% tolonium chloride), whereas the control group received no adjunctive PAD. The parameters of clinical periodontal examination-including probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP) and microbiological assays (PCR) were evaluated before and after treatment. RESULTS After 3 months, both treatment groups showed significant improvements regarding BOP, PD, and CAL compared to baseline, with no significant difference between control and treatment group. The recolonization of Porphyromonas gingivalis and Treponema denticola was reduced after adjuvant treatment, but not significantly. CONCLUSIONS The positive effect of adjunctive PAD regarding clinical parameters was reported in recent trials. In this study and with the current settings, both treatment groups showed similar clinical results after initial periodontal treatment, without beneficial effect of adjunctive PAD.
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Affiliation(s)
- Selma Husejnagic
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Stefan Lettner
- Karl Donath Laboratory, Statistics, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Markus Laky
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Apostolos Georgopoulos
- Core Facility Oral Microbiology and Hygiene, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Andreas Moritz
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Xiaohui Rausch-Fan
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
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Kussovski V, Mantareva V, Durmuş M, Angelov I. Quaternized Zn(II) phthalocyanines for photodynamic strategy against resistant periodontal bacteria. ACTA ACUST UNITED AC 2019; 73:221-228. [PMID: 29306935 DOI: 10.1515/znc-2017-0167] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 11/30/2017] [Indexed: 11/15/2022]
Abstract
Photodynamic inactivation (PDI) has been featured as an effective strategy in the treatment of acute drug-resistant infections. The efficiency of PDI was evaluated against three periodontal pathogenic bacteria that were tested as drug-resistant strains. In vitro studies were performed with four water-soluble cationic Zn(II) phthalocyanines (ZnPc1-4) and irradiation of a specific light source (light-emitting diode, 665 nm) with three doses (15, 36 and 60 J/cm2). The well detectable fluorescence of ZnPcs allowed the cellular imaging, which suggested relatively high uptakes of ZnPcs into bacterial species. Complete photoinactivation was achieved with all studied ZnPc1-4 for Enterococcus faecalis (E. faecalis) at a light dose of 15 J/cm2. The photodynamic response was high for Prevotella intermedia (P. intermedia) after the application of 6 μM of ZnPc1 and a light dose of 36 J/cm2 and for 6 μM of ZnPc2 at 60 J/cm2. P. intermedia was inactivated with ZnPc3 (4 log) and ZnPc4 (2 log) with irradiation at an optimal dose of 60 J/cm2. Similar photoinactivation results (2 log) were achieved for Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) treated with 6 μM ZnPc1 and ZnPc2 at a light dose of 60 J/cm2. The study suggested that PDI with quaternized Zn(II) phthalocyanines and specific light irradiation appears to be a very useful antimicrobial strategy for effective inactivation of drug-resistant periodontal pathogens.
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Affiliation(s)
- Vesselin Kussovski
- The Stephan Angeloff Institute of Microbiology, Bulgarian Academy of Sciences, Acad. G. Bonchev, str., Bl. 26, 1113 Sofia, Bulgaria
| | - Vanya Mantareva
- Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences, Acad. G. Bonchev, str., Bl. 9, 1113 Sofia, Bulgaria, Tel.: +35-92-9606-181
| | - Mahmut Durmuş
- Department of Chemistry, Gebze Technical University, Gebze, 41 400 Kocaeli, Turkey
| | - Ivan Angelov
- Institute of Organic Chemistry with Centre of Phytochemistry, Bulgarian Academy of Sciences, Acad. G. Bonchev, str., Bl. 9, 1113 Sofia, Bulgaria
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Hill G, Dehn C, Hinze AV, Frentzen M, Meister J. Indocyanine green-based adjunctive antimicrobial photodynamic therapy for treating chronic periodontitis: A randomized clinical trial. Photodiagnosis Photodyn Ther 2019; 26:29-35. [DOI: 10.1016/j.pdpdt.2019.02.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/25/2019] [Accepted: 02/22/2019] [Indexed: 10/27/2022]
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Grzech-Leśniak K, Gaspirc B, Sculean A. Clinical and microbiological effects of multiple applications of antibacterial photodynamic therapy in periodontal maintenance patients. A randomized controlled clinical study. Photodiagnosis Photodyn Ther 2019; 27:44-50. [PMID: 31125767 DOI: 10.1016/j.pdpdt.2019.05.028] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 05/12/2019] [Accepted: 05/20/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND At present, very limited data are available on the clinical and microbiological outcomes obtained following repeated application of aPDT following one single mechanical debridement. OBJECTIVE To evaluate clinically and microbiologically the outcomes following one single session of subgingival mechanical debridement (scaling and root planing; e.g. SRP) followed by 1x immediate application of aPDT and 2 x subsequent use of aPDT without SRP. MATERIALS AND METHODS Forty patients diagnosed with generalized chronic periodontitis that were enrolled in periodontal maintenance (supportive periodontal therapy) program, were randomly assigned to one of the two treatments: 1. SRP by means of ultrasonic and hand instruments followed by one single session of SRP followed by 1x immediate application of aPDT and 2 x subsequent applications of aPDT without SRP (test) or 2. SRP alone (control). The following clinical parameters were recorded at baseline, at 3 and 6 months: Full-Mouth Plaque Scores (FMPS), Full-Mouth Bleeding Scores (BOP), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL) and Gingival Recession (RC). Additionally, microbiological samples were evaluated at baseline and six months after treatment. The primary outcome variable was BOP. RESULTS Both treatments improved statistically significantly (p < 0.05) the FMPS, PPD and CAL values, while no statistically significant changes occurred in terms of RC. In the test group, BOP decreased statistically significantly (p < 0.05) after 3 and 6 months, while in the control group the respective values decreased statistically significantly only at 3 months. Both treatments reduced statistically significantly the total bacteria counts (TBC) after 6 months (p < 0.05). At 6 months, the use of SRP and aPDT resulted in a statistically significant decrease in the number of all tested bacteria except A. actinomycetemcomitans while the use of SRP alone resulted only in a statistically significant decrease in the numbers of P. gingivalis, T. denticola and T. forsythia. CONCLUSIONS In periodontal patients enrolled in a maintenance program one single session of SRP followed by 3x application of aPDT, enhanced the clinical and microbiological outcomes compared to SRP alone.
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Affiliation(s)
- K Grzech-Leśniak
- Department of Oral Surgery, Medical University of Wroclaw, Wroclaw, Poland
| | - B Gaspirc
- Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Slovenia
| | - A Sculean
- Department of Periodontology, Dental School University of Bern, Bern, Switzerland.
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Alberton Nuernberg MA, Janjacomo Miessi DM, Ivanaga CA, Bocalon Olivo M, Ervolino E, Gouveia Garcia V, Wainwright M, Theodoro LH. Influence of antimicrobial photodynamic therapy as an adjunctive to scaling and root planing on alveolar bone loss: A systematic review and meta-analysis of animal studies. Photodiagnosis Photodyn Ther 2019; 25:354-363. [DOI: 10.1016/j.pdpdt.2019.01.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 01/08/2019] [Accepted: 01/14/2019] [Indexed: 12/25/2022]
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Chandra S, Shashikumar P. Diode Laser - A Novel Therapeutic Approach in the Treatment of Chronic Periodontitis in Type 2 Diabetes Mellitus Patients: A Prospective Randomized Controlled Clinical Trial. J Lasers Med Sci 2018; 10:56-63. [PMID: 31360370 DOI: 10.15171/jlms.2019.09] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: Maturity-onset diabetes mellitus affecting the elderly population is marked by insulin resistance and decreased insulin production. The relationship between periodontitis and diabetes is bidirectional. Type 2 diabetic patients are more prone to chronic periodontitis (CP) and severe periodontitis affects the glycemic control in such patients. Recently, dental diode laser has become an effective tool in controlling CP. To date, very few studies have been conducted to check the efficacy of diode laser in control of periodontal destruction in type 2 diabetes mellitus (DM2) patients. Hence, the need of the study was to evaluate whether diode laser helps improvement of periodontal outcome and reduction in anaerobic bacteria in elderly diabetic patients with CP. Methods: Forty DM2 patients with CP were randomized into group A (control): scaling and root planing (SRP) only and group B (test): SRP followed by soft tissue dental diode laser (808 nm) application. Four patients (2 in each group) were lost during follow up. Clinical parameters, plaque samples and glycated hemoglobin levels were evaluated at both baseline and 90 days post-treatment. Results: Improvement in clinical, microbiological and glycemic parameters were noted in the group that received SRP as well as SRP + LANAP (laser-assisted new attachment procedure). The reductions in clinical parameters were statistically significant after 3 months (P<0.001). The microbial analysis of plaque samples for Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) decreased significantly after 3 months in group B than in group A. Glycated hemoglobin level (HbA1c) decreased significantly after 90 days in both the groups (P<0.001) with more reduction in the SRP+LANAP group (6.49%) in comparison to SRP alone (16.25% vs. 9.76%). However, on the intergroup comparison, the difference in HbA1c reduction was nonsignificant. Conclusion: Laser as an adjunct to SRP is an effective procedure for improving clinical and microbiological parameters in maturity onset diabetes mellitus patients with CP. Also, there was a better improvement in glycemic control in the test group compared to control group after 3 months. Hence, medically compromised patients like DM2 with CP with delayed wound healing can effectively be treated by laser as an adjunct to nonsurgical periodontal therapy for better results.
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Affiliation(s)
- Sourav Chandra
- Department of Periodontology & Implantology, Hazaribag College of Dental Sciences & Hospital, Hazaribag, Jharkhand825301, India
| | - Pratibha Shashikumar
- Department of Periodontology, JSS Dental College & Hospital (Constituent College), Jagadguru Sri Shivarathreeshwara University, Mysuru- 570015, Karnataka, India
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The effects of repeated applications of antimicrobial photodynamic therapy in the treatment of residual periodontal pockets: a systematic review. Lasers Med Sci 2018; 34:855-863. [DOI: 10.1007/s10103-018-02703-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/03/2018] [Indexed: 01/12/2023]
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Sorbellini E, Rucco M, Rinaldi F. Photodynamic and photobiological effects of light-emitting diode (LED) therapy in dermatological disease: an update. Lasers Med Sci 2018; 33:1431-1439. [PMID: 30006754 PMCID: PMC6133043 DOI: 10.1007/s10103-018-2584-8] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/05/2018] [Indexed: 12/16/2022]
Abstract
Benefit deriving from the use of light is known since ancient time, but, only in the last decades of twentieth century, we witnessed the rapid expansion of knowledge and techniques. Light-emitted diode (LED)-based devices represent the emerging and safest tool for the treatment of many conditions such as skin inflammatory conditions, aging, and disorders linked to hair growth. The present work reviews the current knowledge about LED-based therapeutic approaches in different skin and hair disorders. LED therapy represents the emerging and safest tool for the treatment of many conditions such as skin inflammatory conditions, aging, and disorders linked to hair growth. The use of LED in the treatment of such conditions has now entered common practice among dermatologists. Additional controlled studies are still needed to corroborate the efficacy of such kind of treatment.
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Affiliation(s)
- Elisabetta Sorbellini
- International Hair Research Foundation (IHRF), Milan, Italy.
- Human Advanced Microbiome Project-HMAP, Milan, Italy.
| | | | - Fabio Rinaldi
- International Hair Research Foundation (IHRF), Milan, Italy
- Human Advanced Microbiome Project-HMAP, Milan, Italy
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