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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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2
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Bourbour S, Darbandi A, Bostanghadiri N, Ghanavati R, Taheri B, Bahador A. Effects of Antimicrobial Photosensitizers of Photodynamic Therapy (PDT) to Treat Periodontitis. Curr Pharm Biotechnol 2024; 25:1209-1229. [PMID: 37475551 DOI: 10.2174/1389201024666230720104516] [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: 04/11/2023] [Revised: 06/07/2023] [Accepted: 06/20/2023] [Indexed: 07/22/2023]
Abstract
Antimicrobial photodynamic therapy or aPDT is an alternative therapeutic approach in which lasers and different photosensitizing agents are used to eradicate periodontopathic bacteria in periodontitis. Periodontitis is a localized infectious disease caused by periodontopathic bacteria and can destroy bones and tissues surrounding and supporting the teeth. The aPDT system has been shown by in vitro studies to have high bactericidal efficacy. It was demonstrated that aPDT has low local toxicity, can speed up dental therapy, and is cost-effective. Several photosensitizers (PSs) are available for each type of light source which did not induce any damage to the patient and are safe. In recent years, significant advances have been made in aPDT as a non-invasive treatment method, especially in treating infections and cancers. Besides, aPDT can be perfectly combined with other treatments. Hence, this survey focused on the effectiveness and mechanism of aPDT of periodontitis by using lasers and the most frequently used antimicrobial PSs such as methylene blue (MB), toluidine blue ortho (TBO), indocyanine green (ICG), malachite green (MG) (Triarylmethanes), erythrosine dyes (ERY) (Xanthenes dyes), rose bengal (RB) (Xanthenes dyes), eosin-Y (Xanthenes dyes), radachlorin group and curcumin. The aPDT with these PSs can reduce pathogenic bacterial loads in periodontitis. Therefore, it is clear that there is a bright future for using aPDT to fight microorganisms causing periodontitis.
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Affiliation(s)
- Samaneh Bourbour
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Atieh Darbandi
- Molecular Microbiology Research Center, Shahed University, Tehran, Iran
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Narjess Bostanghadiri
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Roya Ghanavati
- Department of Microbiology, Behbahan Faculty of Medical Sciences, Behbahan, Iran
| | - Behrouz Taheri
- Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Abbas Bahador
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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3
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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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4
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Furcation-involved molar teeth - part 2: management and prognosis. Br Dent J 2022; 233:923-928. [PMID: 36494531 DOI: 10.1038/s41415-022-5254-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 05/23/2022] [Indexed: 12/13/2022]
Abstract
Furcation-involved molars are a common presentation in general dental practice. Teeth with increasing degrees of furcation involvement are at a higher risk of requiring extraction. This second article reviews management and prognosis of furcation-involved molar teeth. An improved understanding of how to appropriately manage these teeth can result in improved outcomes for patients.
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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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The Effect of Photodynamic Therapy on the Early Outcome of Implants Placed on Patients with Periodontitis. PHOTONICS 2022. [DOI: 10.3390/photonics9070480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Immediate implant is a subtype of implant that is placed following tooth extraction within the socket without further delay. These implants are known to preserve the alveolar bone and minimize the total number of surgical interventions in a patient. 4 Photodynamic therapy (PDT) augments nonsurgical periodontal therapy using antibacterial mechanisms. PTD can be more effective in conjunction with scaling and root planing (SRP). The aim of this study is to assess the effects of PDT on the early outcomes of implants placed on patients with periodontitis with and without SRP at 9 months of follow-up. Materials and methods: A total of 23 implants were placed in 14 patients, with 11 in the test group and 12 in the control group. SRP was carried out prior to immediate implant placement in control sites, and PDT adjunctive to SRP (SRP + PDT) was performed in test sites before immediate implant placement. Plaque index, gingival index, probing pocket depth, clinical attachment level, and radiovisiographs were procured at baseline, 3 months, 6 months, and 9 months. Primary stability was examined at the time of implant placement, and the healing index was recorded a week later. Results: At the end of the 9 months of the study period, (SRP + PDT) group had a mean marginal bone loss of 0.95 mm, and the control group had 1.08 mm. Clinical parameters such as plaque index, gingival index, clinical attachment level, and probing depth showed definitive improvement after 9 months, compared with the baseline, but when the test and control groups were compared, the difference was statistically significant for plaque index and probing depth. The implants in both groups were followed up for a period of 9 months. There was an improvement in marginal bone loss but was not statistically significant. The survival of immediate implants in the PDT group was not different from those in the scaling and root planing group. Conclusion: The effect of PTD can be beneficially used as an adjunct to SRP. However, the effects were not significant. Photodynamic therapy can be effectively used as an adjunct to SRP owing to the better outcomes using PDT.
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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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8
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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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9
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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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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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11
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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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12
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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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Laser-Assisted aPDT Protocols in Randomized Controlled Clinical Trials in Dentistry: A Systematic Review. Dent J (Basel) 2020; 8:dj8030107. [PMID: 32971996 PMCID: PMC7558404 DOI: 10.3390/dj8030107] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/13/2020] [Accepted: 09/13/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Antimicrobial photodynamic therapy (aPDT) has been proposed as an effective alternative method for the adjunctive treatment of all classes of oral infections. The multifactorial nature of its mechanism of action correlates with various influencing factors, involving parameters concerning both the photosensitizer and the light delivery system. This study aims to critically evaluate the recorded parameters of aPDT applications that use lasers as the light source in randomized clinical trials in dentistry. METHODS PubMed and Cochrane search engines were used to identify human clinical trials of aPDT therapy in dentistry. After applying specific keywords, additional filters, inclusion and exclusion criteria, the initial number of 7744 articles was reduced to 38. RESULTS Almost one-half of the articles presented incomplete parameters, whilst the others had different protocols, even with the same photosensitizer and for the same field of application. CONCLUSIONS No safe recommendation for aPDT protocols can be extrapolated for clinical use. Further research investigations should be performed with clear protocols, so that standardization for their potential dental applications can be achieved.
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Derikvand N, Hatami M, Chiniforush N, Ghasemi SS. The Use of Antimicrobial Photodynamic Therapy to Maintain a Hopeless Tooth With a PeriodonticEndodontic Lesion: A Case Report. J Lasers Med Sci 2020; 11:355-360. [PMID: 32802298 DOI: 10.34172/jlms.2020.57] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: In spite of some advances in periodontal generative methods, it is impossible to stop progressive Loss of supporting alveolar bone in some end-stage periodontitis. The aim of this study is to report a kind of treatment modality which was seemed to be successes full in maintaining teeth. In this case-report, a hopeless tooth was saved by combined non-surgical periodontalendodontal treatment and antimicrobial photodynamic therapy (aPDT). Case Report: A 58-year-old male presented with a chief complaint of pain and mobility of tooth number 38. Clinical examinations revealed a periodontic-endodontic lesion with clinical attachment loss exceeding 10 mm and grade III mobility. To preserve the tooth, we operated nonsurgical periodontal treatment including scaling and root planning (SRP) plus root canal therapy (RCT) combined with intra-root canal non-aPDT laser decontamination. Then we applied laser pocket therapy with and without aPDT. Following 6 months of the aPDT treatment, the mobility and pocket depth of the tooth improved from grade III to I and from 10 to 3 millimeters respectively. Conclusion: aPDT is a novel adjunctive therapy that can be used for various conditions with microbial etiology. This case report demonstrated that aPDT might be effective in the treatment of periodontic-endodontic lesions in a hopeless tooth.
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Affiliation(s)
- Nahid Derikvand
- Department of Periodontics, Faculty of Dentistry, Borujerd Branch, Islamic Azad University, Borujerd, Iran
| | - Masoud Hatami
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nasim Chiniforush
- Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Impact of Molar Furcations on Photodynamic Therapy Outcomes: A 6-Month Split-Mouth Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114162. [PMID: 32545223 PMCID: PMC7312923 DOI: 10.3390/ijerph17114162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/07/2020] [Accepted: 06/09/2020] [Indexed: 12/29/2022]
Abstract
The effectiveness of adjunctive photodynamic treatment (PDT) to non-surgical periodontal therapy has been shown to depend on initial periodontal status. As molar furcation involvement impairs healing response to non-surgical periodontal therapy, the aim of this study was to evaluate the impact of furcation involvement on PDT outcomes. Thirty-six patients suffering from severe chronic periodontitis were included in a 6-month split-mouth randomized clinical trial. PDT applications used the toluidine blue O and a light-emitting diode (LED) with a red spectrum. Repeated PDT applications were performed in addition to non-surgical periodontal treatment at baseline and at 3-months. Pocket probing depth (PPD), plaque index, bleeding on probing, and clinical attachment level were recorded at baseline, and again at 3- and 6-months. Furcation sites of molars were compared to other sites of molars and non-molars. Multilevel analysis showed no PDT effect in molar furcation sites while an additional significant reduction (odds ratio = 0.67) of pockets with PPD > 5 mm in other sites at 3-months was measured. PPD reduction appeared delayed in molar furcation sites treated with PDT. There is no additional apparent benefit to use PDT in molar furcation sites for the reduction of pockets with PPD > 5 mm contrary to other sites.
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16
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Shitomi K, Miyaji H, Miyata S, Sugaya T, Ushijima N, Akasaka T, Kawasaki H. Photodynamic inactivation of oral bacteria with silver nanoclusters/rose bengal nanocomposite. Photodiagnosis Photodyn Ther 2020; 30:101647. [PMID: 31904554 DOI: 10.1016/j.pdpdt.2019.101647] [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: 08/04/2019] [Revised: 12/24/2019] [Accepted: 12/30/2019] [Indexed: 01/28/2023]
Abstract
Antimicrobial photodynamic therapy (a-PDT) is a promising anti-infective technique for generation of singlet oxygen (1O2) to target dental disease. However, conventional organic photosensitizers have problems for clinical use in terms of cytotoxicity, quenching of a-PDT activity by self-dimerization, and the lack of long-term antibacterial effect. We herein propose silver nanoclusters/rose bengal nanocomposite (AgNCs/RB) as a novel photosensitizer with two primary antibacterial effects: (1) 1O2 generation by irradiated RB and (2) Ag+ ion release from AgNCs. AgNCs/RB irradiated with white light-emitting diode (LED) for a short irradiation time of 1 min significantly decreased the bacterial turbidity of Streptococcus mutans, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans (P < 0.05). In SEM, TEM and LIVE/DEAD staining images, photoexcited AgNCs/RB reduced S. mutans colonization, destroyed the cell membrane, and increased the number of dead cells. The antibacterial efficiency of photoexcited AgNCs/RB was greater than that of AgNCs or RB alone (P < 0.05), suggesting a synergistic effect of 1O2 and Ag+ ions from photoexcited AgNCs/RB. By contrast, photoexcited AgNCs/RB did not affect WST-8 and LDH activities and morphology of NIH3T3 mammalian cells, indicating low cytotoxicity. Interestingly, the antibacterial activity of AgNCs/RB on S. mutans was maintained even after the cessation of LED irradiation, indicating a long-term antibacterial effect due to released Ag+ ions. The present AgNCs/RB photosensitizers provide effective synergistic antibacterial effects for dental a-PDT via 1O2 and Ag+ ions coupled with low cytotoxicity.
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Affiliation(s)
- Kanako Shitomi
- Department of Periodontology and Endodontology, Faculty of Dental Medicine, Hokkaido University, N13 W7, Kita-ku, Sapporo 060-8586, Japan
| | - Hirofumi Miyaji
- Department of Periodontology and Endodontology, Faculty of Dental Medicine, Hokkaido University, N13 W7, Kita-ku, Sapporo 060-8586, Japan.
| | - Saori Miyata
- Department of Periodontology and Endodontology, Faculty of Dental Medicine, Hokkaido University, N13 W7, Kita-ku, Sapporo 060-8586, Japan
| | - Tsutomu Sugaya
- Department of Periodontology and Endodontology, Faculty of Dental Medicine, Hokkaido University, N13 W7, Kita-ku, Sapporo 060-8586, Japan
| | - Natsumi Ushijima
- Support Section for Education and Research, Faculty of Dental Medicine, Hokkaido University, N13 W7, Kita-ku, Sapporo 060-8586, Japan
| | - Tsukasa Akasaka
- Department of Biomedical, Dental Materials and Engineering, Faculty of Dental Medicine, Hokkaido University, N13 W7, Kita-ku, Sapporo 060-8586, Japan
| | - Hideya Kawasaki
- Department of Chemistry and Materials Engineering, Faculty of Chemistry, Materials and Bioengineering, Kansai University, 3-3-35 Yamate-cho, Suita-shi, Osaka 564-8689, Japan.
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17
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Impact of tooth-related factors on photodynamic therapy effectiveness during active periodontal therapy: A 6-months split-mouth randomized clinical trial. Photodiagnosis Photodyn Ther 2019; 27:167-172. [DOI: 10.1016/j.pdpdt.2019.05.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 04/29/2019] [Accepted: 05/17/2019] [Indexed: 12/11/2022]
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18
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Pimentel SP, Casati MZ, Ribeiro FV, Corrêa MG, Franck FC, Benatti BB, Cirano FR. Impact of natural curcumin on the progression of experimental periodontitis in diabetic rats. J Periodontal Res 2019; 55:41-50. [DOI: 10.1111/jre.12683] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 05/17/2019] [Accepted: 06/17/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Suzana P. Pimentel
- Dental Research Division, School of Dentistry Paulista University São Paulo Brazil
| | - Marcio Z. Casati
- Dental Research Division, School of Dentistry Paulista University São Paulo Brazil
| | - Fernanda V. Ribeiro
- Dental Research Division, School of Dentistry Paulista University São Paulo Brazil
| | | | - Felipe C. Franck
- Dental Research Division, School of Dentistry Paulista University São Paulo Brazil
| | - Bruno B. Benatti
- School of Dentistry Federal University of Maranhão São Luís Brazil
| | - Fabiano R. Cirano
- Dental Research Division, School of Dentistry Paulista University São Paulo Brazil
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19
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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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20
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Invernici MM, Salvador SL, Silva PHF, Soares MSM, Casarin R, Palioto DB, Souza SLS, Taba M, Novaes AB, Furlaneto FAC, Messora MR. Effects of Bifidobacterium probiotic on the treatment of chronic periodontitis: A randomized clinical trial. J Clin Periodontol 2018; 45:1198-1210. [PMID: 30076613 PMCID: PMC6221043 DOI: 10.1111/jcpe.12995] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 07/14/2018] [Accepted: 08/01/2018] [Indexed: 02/06/2023]
Abstract
AIM This randomized placebo-controlled clinical trial evaluated the effect of Bifidobacterium animalis subsp. lactis (B. lactis) HN019-containing probiotic lozenges as adjuvant to scaling and root planing (SRP) in patients with generalized chronic periodontitis. MATERIALS AND METHODS Forty-one chronic periodontitis patients were recruited and monitored clinically, immunologically, and microbiologically at baseline (before SRP) and 30 and 90 days after SRP. All patients were randomly assigned to a Test (SRP + Probiotic, n = 20) or Control (SRP + Placebo, n = 21) group. The probiotic lozenges were used twice a day for 30 days. The data were statistically analysed. RESULTS The Test group presented a decrease in probing pocket depth and a clinical attachment gain significantly higher than those of the Control group at 90 days. The Test group also demonstrated significantly fewer periodontal pathogens of red and orange complexes, as well as lower proinflammatory cytokine levels when compared to the Control group. Only the Test group showed an increase in the number of B. lactis HN019 DNA copies on subgingival biofilm at 30 and 90 days. CONCLUSION The use of B. lactis HN019 as an adjunct to SRP promotes additional clinical, microbiological, and immunological benefits in the treatment of chronic periodontitis (NCT03408548).
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Affiliation(s)
- Marcos M Invernici
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Sérgio L Salvador
- Department of Clinical Analyses, School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Pedro H F Silva
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Mariana S M Soares
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Renato Casarin
- Department of Prosthodontics and Periodontics, School of Dentistry, Campinas State University - UNICAMP, Piracicaba, SP, Brazil
| | - Daniela B Palioto
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Sérgio L S Souza
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Mario Taba
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Arthur B Novaes
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Flávia A C Furlaneto
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
| | - Michel R Messora
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo - USP, Ribeirao Preto, SP, Brazil
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Isola G, Matarese G, Williams RC, Siciliano VI, Alibrandi A, Cordasco G, Ramaglia L. The effects of a desiccant agent in the treatment of chronic periodontitis: a randomized, controlled clinical trial. Clin Oral Investig 2018. [PMID: 28624914 DOI: 10.1007/s00784-017-2154-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Chemotherapeutic agents have been widely used as adjuncts for the treatment of chronic periodontitis (CP). This study investigated and compared a desiccant agent as an adjunct to scaling and root planing (SRP) versus SRP alone for the treatment of CP. MATERIALS AND METHODS Thirty-six patients with CP were studied. Using a split-mouth design, the maxillary right and left quadrants were randomly assigned to SRP plus desiccant (Hybenx® EPIEN Medical, Inc. St. Paul, MN, USA) or SRP alone. Patients were examined on a regular basis for clinical, microbiological, and inflammatory mediator changes over a 1-year period. Clinical attachment level (CAL) was the primary outcome variable. In addition, the red complex bacteria and gingival crevicular fluid (GCF) inflammatory mediators were monitored. RESULTS Compared to baseline, both treatments demonstrated an improvement in periodontal parameters. Compared to SRP alone, SRP plus desiccant yielded a significant improvement in probing depth (PD) (SRP: 2.23 ± 0.31 mm vs. desiccant: 3.25 ± 0.57 mm, p < 0.05), CAL (SRP: 3.16 ± 0.29 mm vs. desiccant: 4.21 ± 0.34 mm, p < 0.05 mm) and bleeding on probing (BOP) (SRP: 4.56 ± 1.5% vs. desiccant: 34.23 ± 4.2%, p < 0.001) at 12 months. Similarly, in the SRP plus desiccant group, the bacteria of the red complex were significantly reduced (p < 0.05); and the level of inflammatory mediators was significantly reduced (p < 0.003) compared to SRP alone. CONCLUSIONS SRP plus the desiccant resulted in a greater reduction in clinical, microbial and inflammatory mediators compared to SRP alone. CLINICAL RELEVANCE Desiccant, when combined to SRP, was demonstrated as a significant approach to control the levels of certain periodontal pathogens, inflammatory mediators in patients with CP.
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Affiliation(s)
- Gaetano Isola
- Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, Unit of Periodontology, School of Dentistry, University of Messina, AOU Policlinico "G. Martino", Via Consolare Valeria 1, 98125, Messina, Italy
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine, University of Naples "Federico II", Via G. Pansini 5, 80131, Naples, Italy
| | - Giovanni Matarese
- Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, Unit of Periodontology, School of Dentistry, University of Messina, AOU Policlinico "G. Martino", Via Consolare Valeria 1, 98125, Messina, Italy.
| | - Ray C Williams
- Department of Periodontology, UNC School of Dentistry, Campus Box #7450, Chapel Hill, NC, 27599-7450, USA
| | | | - Angela Alibrandi
- Department of Economics, Unit of Statistics and Mathematical Sciences, University of Messina, Via Pugliatti 1, 98122, Messina, Italy
| | - Giancarlo Cordasco
- Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, Unit of Periodontology, School of Dentistry, University of Messina, AOU Policlinico "G. Martino", Via Consolare Valeria 1, 98125, Messina, Italy
| | - Luca Ramaglia
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine, University of Naples "Federico II", Via G. Pansini 5, 80131, Naples, Italy
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Matarese G, Ramaglia L, Cicciù M, Cordasco G, Isola G. The Effects of Diode Laser Therapy as an Adjunct to Scaling and Root Planing in the Treatment of Aggressive Periodontitis: A 1-Year Randomized Controlled Clinical Trial. Photomed Laser Surg 2017; 35:702-709. [PMID: 28945145 DOI: 10.1089/pho.2017.4288] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate and compare the clinical, microbial, and inflammatory effects of a diode laser as an adjunct to scaling and root planing (SRP) versus SRP alone for the treatment of generalized aggressive periodontitis (GAgP). METHODS Using a split-mouth design, 31 patients with GAgP were enrolled in the study. The maxillary right and left quadrants were randomly assigned to SRP+diode laser or SRP alone. Patients were examined on a regular basis for clinical, microbiological, and inflammatory mediator changes over a 1-year period. Clinical attachment level (CAL) was the primary outcome variable chosen. In addition, subgingival biofilm samples and gingival crevicular fluid (GCF) inflammatory mediators were analyzed at each follow-up session. RESULTS Compared to baseline, both treatments demonstrated an improvement in periodontal parameters at 1 year. However, SRP+diode laser produced a significant improvement in probing depth (PD; 2.56 ± 0.44 vs. 3.36 ± 0.51 mm, p < 0.05) and CAL (3.47 ± 0.25 vs. 4.11 ± 0.26 mm, p < 0.05) values compared to SRP alone. Similarly, in the SRP+diode laser group, the bacteria of orange complex group were significantly reduced at 30 and 60 days compared to SRP alone. Moreover, SRP+diode laser determined a reduction in mean GCF level of interleukin (IL)-1β and IL-1β/IL-10 ratio at 15 and 30 days compared to SRP alone (p < 0.05). CONCLUSIONS At 1 year, SRP+diode laser yielded a significant reduction in some clinical parameters, while microbial and inflammatory mediator changes were not significantly reduced compared to SRP alone.
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Affiliation(s)
- Giovanni Matarese
- 1 Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, School of Dentistry, University of Messina , Messina, Italy
| | - Luca Ramaglia
- 2 Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine, University of Naples "Federico II" , Naples, Italy
| | - Marco Cicciù
- 1 Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, School of Dentistry, University of Messina , Messina, Italy
| | - Giancarlo Cordasco
- 1 Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, School of Dentistry, University of Messina , Messina, Italy
| | - Gaetano Isola
- 1 Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, School of Dentistry, University of Messina , Messina, Italy
- 2 Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine, University of Naples "Federico II" , Naples, Italy
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Is Antimicrobial Photodynamic Therapy Effective as an Adjunct to Scaling and Root Planing in Patients with Chronic Periodontitis? A Systematic Review. Biomolecules 2017; 7:biom7040079. [PMID: 29186805 PMCID: PMC5745461 DOI: 10.3390/biom7040079] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 11/14/2017] [Accepted: 11/20/2017] [Indexed: 11/22/2022] Open
Abstract
The aim of this systematic review was to investigate whether antimicrobial photodynamic therapy (aPDT) as either a primary mode of treatment or an adjunct to non-surgical treatment was more effective than scaling and root planing (SRP) alone in treating chronic periodontitis in terms of clinical attachment level (CAL) gain and probing depth (PD) reduction. The focused question was developed using the Patient, Intervention, Comparison, and Outcome (PICO) format, and two authors independently searched the Medline, EMBASE, Cochrane Library, Web of Science, Google Scholar, and Scopus databases for relevant studies from January 2008 to December 2016. Twenty studies included in this systematic review were randomized clinical trials (RCTs) or quasi-RCTs of aPDT compared to placebo, no intervention, or non-surgical treatment in an adult population. Basic study characteristics, photosensitizing agents and wavelengths used in aPDT, frequency of aPDT application, effect of aPDT on clinical parameters, antimicrobial effect of aPDT in chronic periodontitis, effect of immunological parameters following aPDT and patient-based outcome measures were collected from the studies. Although there was a wide range of heterogeneity in the included studied, they all indicated that aPDT has the potential to be an effective adjunct in the treatment of chronic periodontitis. Long-term, multicenter studies with larger sample sizes are needed before aPDT can be recommended as an effective treatment modality.
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Cobb CM. Lasers and the treatment of periodontitis: the essence and the noise. Periodontol 2000 2017; 75:205-295. [DOI: 10.1111/prd.12137] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Smiley CJ, Tracy SL, Abt E, Michalowicz BS, John MT, Gunsolley J, Cobb CM, Rossmann J, Harrel SK, Forrest JL, Hujoel PP, Noraian KW, Greenwell H, Frantsve-Hawley J, Estrich C, Hanson N. Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. J Am Dent Assoc 2017; 146:508-24.e5. [PMID: 26113099 DOI: 10.1016/j.adaj.2015.01.028] [Citation(s) in RCA: 158] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 01/26/2015] [Accepted: 01/28/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Conduct a systematic review and meta-analysis on nonsurgical treatment of patients with chronic periodontitis by means of scaling and root planing (SRP) with or without adjuncts. METHODS A panel of experts convened by the American Dental Association Council on Scientific Affairs conducted a search of PubMed (MEDLINE) and Embase for randomized controlled trials of SRP with or without the use of adjuncts with clinical attachment level (CAL) outcomes in trials at least 6 months in duration and published in English through July 2014. The authors assessed individual study bias by using the Cochrane Risk of Bias Tool and conducted meta-analyses to obtain the summary effect estimates and their precision and to assess heterogeneity. The authors used funnel plots and Egger tests to assess publication bias when there were more than 10 studies. The authors used a modified version of the US Preventive Services Task Force methods to assess the overall level of certainty in the evidence. RESULTS The panel included 72 articles on the effectiveness of SRP with or without the following: systemic antimicrobials, a systemic host modulator (subantimicrobial-dose doxycycline), locally delivered antimicrobials (chlorhexidine chips, doxycycline hyclate gel, and minocycline microspheres), and a variety of nonsurgical lasers (photodynamic therapy with a diode laser, a diode laser, neodymium:yttrium-aluminum-garnet lasers, and erbium lasers). CONCLUSIONS AND PRACTICAL IMPLICATIONS With a moderate level of certainty, the panel found approximately a 0.5-millimeter average improvement in CAL with SRP. Combinations of SRP with assorted adjuncts resulted in a range of average CAL improvements between 0.2 and 0.6 mm over SRP alone. The panel judged the following 4 adjunctive therapies as beneficial with a moderate level of certainty: systemic subantimicrobial-dose doxycycline, systemic antimicrobials, chlorhexidine chips, and photodynamic therapy with a diode laser. There was a low level of certainty in the benefits of the other included adjunctive therapies. The panel provides clinical recommendations in the associated clinical practice guideline.
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Akram Z, Abduljabbar T, Sauro S, Daood U. Effect of photodynamic therapy and laser alone as adjunct to scaling and root planing on gingival crevicular fluid inflammatory proteins in periodontal disease: A systematic review. Photodiagnosis Photodyn Ther 2016; 16:142-153. [DOI: 10.1016/j.pdpdt.2016.09.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 08/28/2016] [Accepted: 09/08/2016] [Indexed: 01/06/2023]
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da Cruz Andrade PV, Euzebio Alves VT, de Carvalho VF, De Franco Rodrigues M, Pannuti CM, Holzhausen M, De Micheli G, Conde MC. Photodynamic therapy decrease immune-inflammatory mediators levels during periodontal maintenance. Lasers Med Sci 2016; 32:9-17. [PMID: 27704296 DOI: 10.1007/s10103-016-2076-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 09/05/2016] [Indexed: 12/14/2022]
Abstract
Antimicrobial photodynamic therapy (aPDT) was introduced as a promising adjuvant therapy on the periodontal treatment. The aim of this study was to evaluate the effect of aPDT on inflammatory mediator levels in residual periodontal pockets of patients with severe chronic periodontitis under periodontal maintenance, during 12 months follow-up. A randomized controlled trial study was conducted in 28 patients with severe chronic periodontitis. After non-surgical periodontal treatment, patients with at least four teeth with residual pocket probing depth (PPD) ≥4 mm were randomly assigned to either aPDT or control group. The aPDT (low power laser: 660 nm, 40 mW, 90 J/cm2, methylene blue 0.01 %) was performed at baseline and 3, 6, and 9 months. Clinical parameters were collected before and 3 and 12 months after the intervention, and gingival crevicular fluid was collected in the same times, including 1 week after the intervention. Immunological evaluation was carried out using the Luminex assay which quantified the expression of ten cytokines: interleukin (IL)-1α, IL-1β, IL-8, IL-1ra, fibroblast growth factor (FGF), vascular endothelial growth factor (VEGF), interferon (IFN)-γ, tumor necrosis factor (TNF)-α, IL-4, and IL-10. All clinical variables showed significant improvement for both groups, but there was no statistical difference between groups with no clinical benefits. IL-1α, IL-1β, IL-8, and VEGF showed significant differences (p < 0.05) between groups, whereas IL-1ra mediators, IFN-γ, and IL-10 demonstrated a statistical difference (p < 0.01) over time in the same group. At any time, FGF, IL-4, and TNF-α showed no statistical difference between groups (p > 0.05). aPDT therapy can improve the benefits on inflammation control during the periodontal maintenance.
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Affiliation(s)
- Priscila Vivas da Cruz Andrade
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, Avenida Professor Lineu Prestes, 2227, Cidade Universitaria, Sao Paulo, SP, CEP: 05508-000, Brazil
| | - Vanessa Tubero Euzebio Alves
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, Avenida Professor Lineu Prestes, 2227, Cidade Universitaria, Sao Paulo, SP, CEP: 05508-000, Brazil
| | - Verônica Franco de Carvalho
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, Avenida Professor Lineu Prestes, 2227, Cidade Universitaria, Sao Paulo, SP, CEP: 05508-000, Brazil
| | - Michelle De Franco Rodrigues
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, Avenida Professor Lineu Prestes, 2227, Cidade Universitaria, Sao Paulo, SP, CEP: 05508-000, Brazil
| | - Claudio Mendes Pannuti
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, Avenida Professor Lineu Prestes, 2227, Cidade Universitaria, Sao Paulo, SP, CEP: 05508-000, Brazil
| | - Marinella Holzhausen
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, Avenida Professor Lineu Prestes, 2227, Cidade Universitaria, Sao Paulo, SP, CEP: 05508-000, Brazil
| | - Giorgio De Micheli
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, Avenida Professor Lineu Prestes, 2227, Cidade Universitaria, Sao Paulo, SP, CEP: 05508-000, Brazil
| | - Marina Clemente Conde
- Division of Periodontics, Department of Stomatology, School of Dentistry, University of Sao Paulo, Avenida Professor Lineu Prestes, 2227, Cidade Universitaria, Sao Paulo, SP, CEP: 05508-000, Brazil.
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Abduljabbar T, Javed F, Shah A, Samer MS, Vohra F, Akram Z. Role of lasers as an adjunct to scaling and root planing in patients with type 2 diabetes mellitus: a systematic review. Lasers Med Sci 2016; 32:449-459. [DOI: 10.1007/s10103-016-2086-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 09/21/2016] [Indexed: 12/31/2022]
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Kellesarian SV, Malignaggi VR, Abduljabbar T, Vohra F, Malmstrom H, Romanos GE, Javed F. Efficacy of scaling and root planing with and without adjunct antimicrobial photodynamic therapy on the expression of cytokines in the gingival crevicular fluid of patients with periodontitis: A systematic review. Photodiagnosis Photodyn Ther 2016; 16:76-84. [PMID: 27609013 DOI: 10.1016/j.pdpdt.2016.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 08/27/2016] [Accepted: 08/28/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of the present review was to study the efficacy of scaling and root planing (SRP) with and without adjunct antibacterial photodynamic therapy (aPDT) on the expression of cytokines in the gingival crevicular fluid (GCF) of patients with periodontitis. METHODS In order to address the focused question: "What is the efficacy of SRP with and without aPDT on the expression of cytokines in the GCF of patients with periodontitis" an electronic search without time or language restrictions was conducted up to and including July 2016 in indexed databases using various key words. The exclusion criteria included reviews, laboratory and experimental studies, case reports, commentaries, letters to the editor, interviews, updates, studies where intervention group received aPDT without previous SRP, and studies where local delivery of antibiotics was used as adjunctive therapy to aPDT. RESULTS Six randomized control trials were included in the present systematic review. All studies included a control group which received only SRP. Results from 34% of studies reported lower cytokine levels among individuals receiving adjunct aPDT to SPT compared to patients receiving SRP alone. Selective cytokines reduction in the GCF following SRP with adjunct aPDT compared with SRP alone was reported in 50% of the studies. In one study SRP with adjunct aPDT failed to reduce GCF cytokine concentration. CONCLUSION From the literature reviewed the efficacy aPDT as adjunct to SRP in downregulating GCF cytokines remains debatable. Further well-designed studies are needed in this regard.
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Affiliation(s)
- Sergio Varela Kellesarian
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA.
| | | | - Tariq Abduljabbar
- Department of Prosthetic Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Hans Malmstrom
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA
| | - Georgios E Romanos
- Department of Oral Surgery and Implant Dentistry, Dental School, Johann Wolfgang Goethe, University of Frankfurt, Frankfurt, Germany; Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Fawad Javed
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, NY, USA
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Castro dos Santos NC, Andere NMRB, Araujo CF, de Marco AC, dos Santos LM, Jardini MAN, Santamaria MP. Local adjunct effect of antimicrobial photodynamic therapy for the treatment of chronic periodontitis in type 2 diabetics: split-mouth double-blind randomized controlled clinical trial. Lasers Med Sci 2016; 31:1633-1640. [DOI: 10.1007/s10103-016-2030-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 07/12/2016] [Indexed: 11/25/2022]
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Stadler AF, Angst PDM, Arce RM, Gomes SC, Oppermann RV, Susin C. Gingival crevicular fluid levels of cytokines/chemokines in chronic periodontitis: a meta-analysis. J Clin Periodontol 2016; 43:727-45. [PMID: 27027257 DOI: 10.1111/jcpe.12557] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2016] [Indexed: 12/14/2022]
Abstract
AIMS To compare gingival crevicular fluid (GCF) cytokines/chemokines levels between periodontally healthy subjects and subjects diagnosed with chronic periodontitis (ChP), before and after non-surgical periodontal treatment, and to establish their predictive value for periodontal disease progression. METHODS Studies indexed in MEDLINE and EMBASE published in English, Portuguese and Spanish were eligible for this review. Database searches up to December 2015, and manual search of the reference list from reviews and selected articles was performed. Only studies providing data on GCF cytokines/chemokines levels in subjects diagnosed with ChP and periodontally healthy controls were included. Cross-sectional, case series, single-arm clinical studies, randomized controlled trials and prospective/retrospective cohort studies were included. Meta-analyses were conducted for those cytokines/chemokines with at least three available studies. RESULTS GCF levels of IL-1β, IL-6, IFN-γ and MCP-1/CCL2 were significantly higher in subjects diagnosed with ChP than periodontally healthy subjects. A significant decrease in GCF levels of IL-1β and IL-17 was observed after non-surgical periodontal treatment, whereas a significant increase was observed for IL-4. CONCLUSION Evidence for significant differences between periodontal health and ChP was observed for a few cytokines and one chemokine. No conclusions could be drawn with regards to increased risk of disease progression.
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Affiliation(s)
- Amanda F Stadler
- Section of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.,Department of Periodontics, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Patrícia D M Angst
- Section of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Roger M Arce
- Department of Periodontics, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Sabrina C Gomes
- Section of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rui V Oppermann
- Section of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Cristiano Susin
- Department of Periodontics, Dental College of Georgia, Augusta University, Augusta, GA, USA
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Akram Z, Al-Shareef SAA, Daood U, Asiri FY, Shah AH, AlQahtani MA, Vohra F, Javed F. Bactericidal Efficacy of Photodynamic Therapy Against Periodontal Pathogens in Periodontal Disease: A Systematic Review. Photomed Laser Surg 2016; 34:137-49. [DOI: 10.1089/pho.2015.4076] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Zohaib Akram
- Faculty of Dentistry, Department of Periodontology, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Umer Daood
- Faculty of Dentistry, Department of Paediatric Dentistry, Prince Philip Dental Hospital, University of Hong Kong, Hong Kong
| | - Faris Yahya Asiri
- Department of Preventive Dental Sciences, College of Dentistry, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Altaf H. Shah
- Department of Preventive Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - M. Ayedh AlQahtani
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fawad Javed
- Advanced General Dentistry. Division of General Dentistry, Eastman Institute for Oral Health, University of Rochester, New York
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Evaluation of photodynamic therapy on fibroblast viability and cytokine production. Photodiagnosis Photodyn Ther 2016; 13:97-100. [DOI: 10.1016/j.pdpdt.2016.01.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 12/19/2015] [Accepted: 01/14/2016] [Indexed: 11/18/2022]
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Betsy J, Prasanth CS, Baiju KV, Presanthila J, Subhash N. Patients' perceptions of antimicrobial photodynamic therapy in the management of chronic periodontitis. Photodiagnosis Photodyn Ther 2016; 14:84-90. [PMID: 26805006 DOI: 10.1016/j.pdpdt.2016.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 12/18/2015] [Accepted: 01/06/2016] [Indexed: 12/11/2022]
Abstract
The aim of this study is to evaluate patients' perception of antimicrobial photodynamic therapy (aPDT) in the management of chronic periodontitis. 90 patients (51 females and 39 males) with untreated localized chronic periodontitis were randomly assigned to receive SRP with aPDT (test group) or SRP alone (control group) in a single-centered double-blinded randomized and controlled clinical trial. Patients' perception in terms of changes in bleeding gums, pain in gums while chewing, bad breath and sensitive gums along with pain during the procedure and patient acceptance were recorded for 6 months after treatment by a periodontist who was blinded to the procedure. Inter-group and intra-group statistical analyses were performed. Significant difference between the frequencies of two groups with respect to each variable was assessed using non-parametric test. Patients' report of bleeding gums and pain in the gums while chewing showed statistically significant reduction in the test group at 2 weeks and 1 month (p<0.05). Also, a significant difference was detected at 1 month between SRP and SRP+aPDT in terms of halitosis (p<0.05). No statistically significant change was observed between two groups in terms of sensitive gums, pain during procedure and patient acceptance. Patients perceived short-term benefits of single session of aPDT therapy due to the reduction in bleeding gums, halitosis and pain while chewing following treatment. Further studies are required to assess the effectiveness of aPDT for a longer-term and following multiple sessions.
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Affiliation(s)
- Joseph Betsy
- Department of Periodontics, Government Dental College, Thiruvananthapuram, 695011 Kerala, India.
| | - Chandra Sekhar Prasanth
- Biophotonics Laboratory, Centre for Earth Science Studies, Akkulam, Thiruvananthapuram, 695031 Kerala, India
| | | | - Janam Presanthila
- Department of Periodontics, Government Dental College, Thiruvananthapuram, 695011 Kerala, India
| | - Narayanan Subhash
- Biophotonics Laboratory, Centre for Earth Science Studies, Akkulam, Thiruvananthapuram, 695031 Kerala, India
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Corrêa MG, Oliveira DH, Saraceni CHC, Ribeiro FV, Pimentel SP, Cirano FR, Casarin RCV. Short-term microbiological effects of photodynamic therapy in non-surgical periodontal treatment of residual pockets: A split-mouth RCT. Lasers Surg Med 2015; 48:944-950. [DOI: 10.1002/lsm.22449] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Mônica Grazieli Corrêa
- Dental Research Division; School of Dentistry; Paulista University; São Paulo São Paulo Brazil
| | - Deborah Haydee Oliveira
- Dental Research Division; School of Dentistry; Paulista University; São Paulo São Paulo Brazil
| | | | - Fernanda Vieira Ribeiro
- Dental Research Division; School of Dentistry; Paulista University; São Paulo São Paulo Brazil
| | - Suzana Peres Pimentel
- Dental Research Division; School of Dentistry; Paulista University; São Paulo São Paulo Brazil
| | - Fabiano Ribeiro Cirano
- Dental Research Division; School of Dentistry; Paulista University; São Paulo São Paulo Brazil
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Souza E, Medeiros AC, Gurgel BC, Sarmento C. Antimicrobial photodynamic therapy in the treatment of aggressive periodontitis: a systematic review and meta-analysis. Lasers Med Sci 2015; 31:187-96. [DOI: 10.1007/s10103-015-1836-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Accepted: 11/05/2015] [Indexed: 01/12/2023]
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Sculean A, Aoki A, Romanos G, Schwarz F, Miron RJ, Cosgarea R. Is Photodynamic Therapy an Effective Treatment for Periodontal and Peri-Implant Infections? Dent Clin North Am 2015; 59:831-858. [PMID: 26427570 DOI: 10.1016/j.cden.2015.06.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Antimicrobial photodynamic therapy (PDT) has attracted much attention for the treatment of pathogenic biofilm associated with peridontitis and peri-implantitis. However, data from randomized controlled clinical studies (RCTs) are limited and, to some extent, controversial, making it difficult to provide appropriate recommendations. Therefore, the aims of the present study were (a) to provide an overview on the current evidence from RCTs evaluating the potential clinical benefit for the additional use of PDT to subgingival mechanical debridement (ie, scaling and root planing) alone in nonsurgical periodontal therapy; and (b) to provide clinical recommendations for the use of PDT in periodontal practice.
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Affiliation(s)
- Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstr. 7, 3010 Bern, Switzerland.
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - George Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Frank Schwarz
- Department of Oral Surgery, Heinrich Heine University, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Richard J Miron
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstr. 7, 3010 Bern, Switzerland
| | - Raluca Cosgarea
- Department of Periodontology, Philipps University Marburg, Georg-Voigt-Str. 3, 35039 Marburg, Germany; Department of Prosthodontics, Iuliu Hatieganu University, Clinicilor str. 32, 400506 Cluj-Napoca, Romania
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Antimicrobial photodynamic therapy: A promise candidate for caries lesions treatment. Photodiagnosis Photodyn Ther 2015; 12:511-8. [DOI: 10.1016/j.pdpdt.2015.04.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 03/20/2015] [Accepted: 04/13/2015] [Indexed: 01/09/2023]
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Smiley CJ, Tracy SL, Abt E, Michalowicz BS, John MT, Gunsolley J, Cobb CM, Rossmann J, Harrel SK, Forrest JL, Hujoel PP, Noraian KW, Greenwell H, Frantsve-Hawley J, Estrich C, Hanson N. Evidence-based clinical practice guideline on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. J Am Dent Assoc 2015; 146:525-35. [DOI: 10.1016/j.adaj.2015.01.026] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 01/26/2015] [Accepted: 01/28/2015] [Indexed: 10/23/2022]
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Carvalho VF, Andrade PVC, Rodrigues MF, Hirata MH, Hirata RDC, Pannuti CM, De Micheli G, Conde MC. Antimicrobial photodynamic effect to treat residual pockets in periodontal patients: a randomized controlled clinical trial. J Clin Periodontol 2015; 42:440-7. [PMID: 25808980 DOI: 10.1111/jcpe.12393] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2015] [Indexed: 01/05/2023]
Abstract
AIM A randomized controlled clinical trial was designed to evaluate the efficacy of the photodynamic therapy (PDT) in the treatment of residual pockets of chronic periodontitis patients. MATERIAL AND METHODS Thirty-four patients with at least four residual periodontal pockets undergoing maintenance care were included and randomly assigned to test group (PDT, n = 18) or control group (sham procedure, n = 16). The intervention was performed at baseline, 3, 6 and 12 months. Clinical parameters such as pocket probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BoP) and plaque index (PI) were measured before intervention and after 3, 6 and 12 months. Subgingival samples were obtained at baseline, and after 7 days, 3, 6 and 12 months to quantify Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia by real-time polimerase chain reaction (PCR). RESULTS All clinical variables showed significant improvement during the study, but there was no significant difference between test and control groups. The microbiological analyses showed no differences between groups at any time during the study. CONCLUSION Within the limits of this clinical trial and considering the laser and photosensitizer protocol used, PDT failed to demonstrate additional clinical and bacteriological benefits in residual pockets treatment.
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Affiliation(s)
- Verônica F Carvalho
- Department of Periodontology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Priscila V C Andrade
- Department of Periodontology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Michelle F Rodrigues
- Department of Periodontology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Mario H Hirata
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Rosario D C Hirata
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Claudio M Pannuti
- Department of Periodontology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Giorgio De Micheli
- Department of Periodontology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Marina C Conde
- Department of Periodontology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
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Moreira AL, Novaes AB, Grisi MF, Taba M, Souza SL, Palioto DB, de Oliveira PG, Casati MZ, Casarin RC, Messora MR. Antimicrobial Photodynamic Therapy as an Adjunct to Non-Surgical Treatment of Aggressive Periodontitis: A Split-Mouth Randomized Controlled Trial. J Periodontol 2015; 86:376-86. [DOI: 10.1902/jop.2014.140392] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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A practical approach to evidence-based dentistry: III: how to appraise and use an article about therapy. J Am Dent Assoc 2014; 146:42-49.e1. [PMID: 25569497 DOI: 10.1016/j.adaj.2014.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OVERVIEW Dental practitioners spend most of their time administering treatments. To ensure that their clinical decisions are informed by the best available evidence, dental practitioners need to be skilled in critically appraising studies addressing therapy issues. Randomized controlled trials offer the optimal study design to inform decisions regarding therapy. The critical appraisal of randomized controlled trials involves assessing the risk of bias, results, and applicability. In this article, the authors present these concepts and provide guidance for this type of appraisal. PRACTICAL IMPLICATIONS Dentists who wish to inform their clinical decisions regarding therapy and prevention questions can use these guidelines to decide what type of studies to search, define the specific question of interest to search efficiently for these studies, and critically appraise an article about therapy or prevention.
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Kolbe MF, Ribeiro FV, Luchesi VH, Casarin RC, Sallum EA, Nociti FH, Ambrosano GM, Cirano FR, Pimentel SP, Casati MZ. Photodynamic Therapy During Supportive Periodontal Care: Clinical, Microbiologic, Immunoinflammatory, and Patient-Centered Performance in a Split-Mouth Randomized Clinical Trial. J Periodontol 2014; 85:e277-86. [DOI: 10.1902/jop.2014.130559] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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