1
|
Najm KK, Gul SS, Abdulkareem AA. Efficacy of Non-Surgical Periodontal Therapy with Adjunctive Methylene Blue and Toluidine Blue O Mediated Photodynamic in Treatment of Periodontitis: A Randomized Clinical Trial. Clin Pract 2024; 14:954-964. [PMID: 38804408 PMCID: PMC11130800 DOI: 10.3390/clinpract14030076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/14/2024] [Accepted: 05/20/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND This study aimed to examine the efficacy of methylene blue (MB) and toluidine blue O (TBO) photodynamic therapy (PDT) as adjuncts to root surface debridement (RSD). METHODS This split-mouth, randomized, controlled clinical trial included eighteen patients, and a total of 332 sites (control = 102, MB = 124 and TBO = 106) were examined. Two sessions of PDT were completed at baseline and two weeks after RSD. Clinical parameters of bleeding on probing (BOP), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were measured pre- and post-treatment. RESULTS PPD and BOP reductions in sites treated by RSD with adjunctive photosensitizers (MB and TBO) were significantly higher than in control sites. RSD with MB showed higher efficacy in improving moderately deep pockets (OR 3.350), while adjunctive TBO showed better results in treating deeper pockets (OR 4.643). CONCLUSIONS Results suggested that adjunctive use of MB and TBO to RSD could significantly improve periodontal pocket closure and reduce signs of inflammation. In addition, TBO seems to be more efficient in treating deep periodontal pockets than MB, which is more effective in resolving shallower pockets.
Collapse
Affiliation(s)
- Kashan Kamal Najm
- Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaymaniyah 46001, Iraq;
| | - Sarhang Sarwat Gul
- Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaymaniyah 46001, Iraq;
- Medical Laboratory Department, College of Health and Medical Technology, Sulaimani Polytechnic University, Sulaymaniyah 46001, Iraq
| | - Ali Abbas Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad 10011, Iraq;
| |
Collapse
|
2
|
Mahdizade Ari M, Amirmozafari N, Atieh Darbandi, Afifirad R, Asadollahi P, Irajian G. Effectiveness of photodynamic therapy on the treatment of chronic periodontitis: a systematic review during 2008-2023. Front Chem 2024; 12:1384344. [PMID: 38817441 PMCID: PMC11138352 DOI: 10.3389/fchem.2024.1384344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/10/2024] [Indexed: 06/01/2024] Open
Abstract
Objective This study investigated the effect of photodynamic therapy on chronic periodontitis patients and then evaluated the microbial, immunological, periodontal, and clinical outcomes. The significant effects of photodynamic therapy obtained by in vitro and in vivo studies have made it a popular treatment for periodontal diseases in recent years. Photodynamic therapy is a novel bactericidal strategy that is stronger, faster, and less expensive than scaling and root planing. Method This study registered on PROSPERO (CRD42021267008) and retrieved fifty-three randomized controlled trials by searching nine databases (Medline, Embase, Scopus, Open Gray, Google Scholar, ProQuest, the Cochrane Library, Web of Science, and ClinicalTrials.gov) from 2008 to 2023. Of 721 records identified through database searches following title and full-text analysis, and excluding duplicate and irrelevant publications, 53 articles were included in this systematic review. Fifty of the 53 eligible studies fulfilled all the criteria in the Joanna Briggs Institute's (JBI's) Checklist for RCTs; the remaining articles met 9-12 criteria and were considered high quality. Results The present study showed that photodynamic therapy in adjunct to scaling and root planing has the potential to improve periodontal parameters such as clinical attachment loss or gain, decrease in bleeding on probing, and probing pocket depth. In addition, photodynamic therapy decreases the rate of periodontal pathogens and inflammation markers, which, in turn, reduces the progression of periodontitis. Conclusion Photodynamic therapy is considered a promising, adjunctive, and low-cost therapeutic method that is effective in tissue repair, reducing chronic periodontitis, reducing inflammation, and well-tolerated by patients.
Collapse
Affiliation(s)
- Marzie Mahdizade Ari
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Microbial Biotechnology Research Center, University of Medical Sciences, Tehran, Iran
| | - Nour Amirmozafari
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Atieh Darbandi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Microbial Biotechnology Research Center, University of Medical Sciences, Tehran, Iran
| | - Roghayeh Afifirad
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Parisa Asadollahi
- Department of Microbiology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Gholamreza Irajian
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Microbial Biotechnology Research Center, University of Medical Sciences, Tehran, Iran
| |
Collapse
|
3
|
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).
Collapse
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
| |
Collapse
|
4
|
Clinical Efficacy and Safety of Antimicrobial Photodynamic Therapy in Residual Periodontal Pockets during the Maintenance Phase. Pharmaceuticals (Basel) 2022; 15:ph15080924. [PMID: 35893748 PMCID: PMC9332381 DOI: 10.3390/ph15080924] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/19/2022] [Accepted: 07/24/2022] [Indexed: 02/04/2023] Open
Abstract
Antimicrobial photodynamic therapy (a-PDT) in combination with scaling root planing (SRP) is more effective at improving periodontal status than SRP alone. However, the effectiveness of a-PDT in combination with irrigation for patients undergoing periodontal maintenance has not been clarified. This study evaluated the efficacy and safety of a-PDT in the maintenance phase. Patients who had multiple sites with bleeding on probing (BOP) and periodontal probing depth (PPD) of 4–6 mm in the maintenance phase were treated with a split-mouth design. These sites were randomly assigned to one of two groups: the a-PDT group and the irrigation group. In the a-PDT group, the periodontal pockets were treated with light-sensitive toluidine blue and a light irradiator. In the irrigation group, the periodontal pockets were simply irrigated using an ultrasonic scaler. After 7 days, the safety and efficacy of a-PDT were assessed. The mean PPD of the a-PDT group had reduced from 4.50 mm to 4.13 mm, whereas negligible change was observed in the irrigation group. BOP significantly improved from 100% to 33% in the PDT group, whereas it hardly changed in the irrigation group. No adverse events were observed in any patients. a-PDT may be useful as a noninvasive treatment in the maintenance phase, especially in patients with relatively deep periodontal pocket.
Collapse
|
5
|
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.
Collapse
|
6
|
Dalvi S, Benedicenti S, Sălăgean T, Bordea IR, Hanna R. Effectiveness of Antimicrobial Photodynamic Therapy in the Treatment of Periodontitis: A Systematic Review and Meta-Analysis of In Vivo Human Randomized Controlled Clinical Trials. Pharmaceutics 2021; 13:pharmaceutics13060836. [PMID: 34200078 PMCID: PMC8228221 DOI: 10.3390/pharmaceutics13060836] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/25/2021] [Accepted: 06/02/2021] [Indexed: 02/06/2023] Open
Abstract
This systematic review and meta-analysis evaluated antimicrobial photodynamic therapy (aPDT) efficacy in periodontitis. The review protocol was conducted in accordance with PRISMA statements, Cochrane Collaboration recommendations and is registered in PROSPERO (CRD 42020161516). Electronic and hand search strategies were undertaken to gather data on in vivo human RCTs followed by qualitative analysis. Differences in probing pocket depth (PPD) and clinical attachment level (CAL) were calculated with 95% confidence intervals and pooled in random effects model at three and six months. Heterogeneity was analyzed, using Q and I2 tests. Publication bias was assessed by visual examination of the funnel plot symmetry. Sixty percent of 31 eligible studies showed a high risk of bias. Meta-analysis on 18 studies showed no additional benefit in split mouth studies in terms of PPD reduction (SMD 0.166; 95% CI −0.278 to 0.611; P = 0.463) and CAL gain (SMD 0.092; 95% CI −0.013 to 0.198; P = 0.088). Similar findings noted for parallel group studies; PPD reduction (SMD 0.076; 95% CI −0.420 to 0.573; P = 0.763) and CAL gain (SMD 0.056; 95% CI −0.408 to 0.552; P = 0.745). Sensitivity analysis minimized heterogeneity for both outcome variables; however, intergroup differences were not statistically significant. Future research should aim for well-designed RCTs in order to determine the effectiveness of aPDT.
Collapse
Affiliation(s)
- Snehal Dalvi
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy; (S.B.); (R.H.)
- Department of Periodontology, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur 441110, India
- Correspondence: (S.D.); (T.S.); Tel.: +39-0-103-537-446 (S.D.); +40-744-707-371 (T.S.)
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy; (S.B.); (R.H.)
| | - Tudor Sălăgean
- Department of Land Measurements and Exact Sciences, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania
- Correspondence: (S.D.); (T.S.); Tel.: +39-0-103-537-446 (S.D.); +40-744-707-371 (T.S.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania;
| | - Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy; (S.B.); (R.H.)
- Department of Oral Surgery, Dental Institute, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK
| |
Collapse
|
7
|
Salvi GE, Stähli A, Schmidt JC, Ramseier CA, Sculean A, Walter C. Adjunctive laser or antimicrobial photodynamic therapy to non-surgical mechanical instrumentation in patients with untreated periodontitis: A systematic review and meta-analysis. J Clin Periodontol 2021; 47 Suppl 22:176-198. [PMID: 31859395 DOI: 10.1111/jcpe.13236] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 12/07/2019] [Accepted: 12/14/2019] [Indexed: 12/13/2022]
Abstract
AIM To compare the adjunctive effects of lasers or antimicrobial photodynamic therapy (aPDT) to non-surgical mechanical instrumentation alone in untreated periodontitis patients. MATERIALS AND METHODS Two focused questions were addressed using the Population, Intervention, Comparison and Outcome criteria as follows: in patients with untreated periodontitis, (a) does laser application provide adjunctive effects on probing pocket depth (PPD) changes compared with non-surgical instrumentation alone? and (b) does application of aPDT provide adjunctive effects on PPD changes compared with non-surgical instrumentation alone? Both randomized controlled clinical trials (RCTs) and controlled clinical trials (CCTs) were included. Results of the meta-analysis are expressed as weighted mean differences (WMD) and reported according to the PRISMA guidelines. RESULTS Out of 1,202 records, 10 articles for adjunctive laser and 8 for adjunctive aPDT were included. With respect to PPD changes, 1 meta-analysis including 2 articles (total n = 42; split-mouth design) failed to identify a statistically significant difference (WMD = 0.35 mm; 95%CI: -0.04/0.73; p = .08) in favour of adjunctive aPDT (wavelength range 650-700 nm). In terms of adjunctive laser application, a high variability of clinical outcomes at 6 months was noted. Two articles included patient-reported outcomes and 10 reported on the presence/absence of harms/adverse effects. CONCLUSIONS Available evidence on adjunctive therapy with lasers and aPDT is limited by (a) the low number of controlled studies and (b) the heterogeneity of study designs. Patient-reported benefits remain to be demonstrated.
Collapse
Affiliation(s)
- Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Julia C Schmidt
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine (UZB), University of Basel, Basel, Switzerland
| | - Christoph A Ramseier
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Clemens Walter
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine (UZB), University of Basel, Basel, Switzerland
| |
Collapse
|
8
|
Salvi GE, Stähli A, Schmidt JC, Ramseier CA, Sculean A, Walter C. Reply letter to the editor. J Clin Periodontol 2021; 48:553-554. [PMID: 33527412 DOI: 10.1111/jcpe.13431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/05/2021] [Accepted: 01/15/2021] [Indexed: 02/03/2023]
Affiliation(s)
- Giovanni E Salvi
- School of Dental Medicine, Department of Periodontology, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- School of Dental Medicine, Department of Periodontology, University of Bern, Bern, Switzerland
| | - Julia C Schmidt
- Department of Periodontology, Endodontology and Cariology, University of Basel, University Center for Dental Medicine (UZB), Basel, Switzerland
| | - Christoph A Ramseier
- School of Dental Medicine, Department of Periodontology, University of Bern, Bern, Switzerland
| | - Anton Sculean
- School of Dental Medicine, Department of Periodontology, University of Bern, Bern, Switzerland
| | - Clemens Walter
- Department of Periodontology, Endodontology and Cariology, University of Basel, University Center for Dental Medicine (UZB), Basel, Switzerland
| |
Collapse
|
9
|
Damante CA. Laser parameters in systematic reviews. J Clin Periodontol 2021; 48:550-552. [PMID: 33522004 DOI: 10.1111/jcpe.13421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/09/2020] [Accepted: 01/10/2021] [Indexed: 01/10/2023]
Affiliation(s)
- Carla Andreotti Damante
- Discipline of Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil
| |
Collapse
|
10
|
Matsushima Y, Yashima A, Fukaya M, Shirakawa S, Ohshima T, Kawai T, Nagano T, Gomi K. Effects of Antimicrobial Photodynamic Therapy on Organic Solution and Root Surface In Vitro. Antibiotics (Basel) 2021; 10:101. [PMID: 33494221 PMCID: PMC7909815 DOI: 10.3390/antibiotics10020101] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/13/2021] [Accepted: 01/19/2021] [Indexed: 11/16/2022] Open
Abstract
Antimicrobial photodynamic therapy (a-PDT) is attracting attention as a new form of dental treatment. While it is primarily applied to produce an antibacterial effect, it decreases lipopolysaccharide (LPS) and protease activity. Here, we evaluated differences in the antibacterial activity of a-PDT on three types of bacteria and the effects on the organic substances (i.e., albumin and LPS). Furthermore, we investigated the effects of a-PDT on root surfaces. A FotoSan630® and toluidine blue were used to perform a-PDT in this study. We measured its antimicrobial activity against Porphyromonas gingivalis, Streptococcus mutans, and Enterococcus faecalis. Antimicrobial testing revealed strong antimicrobial action and P. gingivalis, E. faecalis, and S. mutans were almost undetectable after 50, 120, and 100 s, respectively. In organic resolution tests, albumin was significantly decreased from 1 min after a-PDT application onward, while LPS significantly decreased at 5 min after the application. The root surfaces after a-PDT were confirmed to be cleaner than the controls without suffering any damage. Depending on the bacterial species, a-PDT exhibited antimicrobial activity against various types of bacteria and sensitivity differed. Moreover, we reported that a-PDT resolves protein and LPS, enabling the formation of a healthy root surface without any damage.
Collapse
Affiliation(s)
- Yuji Matsushima
- Department of Periodontology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi ku, Yokohama 230-8501, Japan; (Y.M.); (A.Y.); (M.F.); (S.S.); (T.N.)
| | - Akihiro Yashima
- Department of Periodontology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi ku, Yokohama 230-8501, Japan; (Y.M.); (A.Y.); (M.F.); (S.S.); (T.N.)
| | - Meri Fukaya
- Department of Periodontology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi ku, Yokohama 230-8501, Japan; (Y.M.); (A.Y.); (M.F.); (S.S.); (T.N.)
| | - Satoshi Shirakawa
- Department of Periodontology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi ku, Yokohama 230-8501, Japan; (Y.M.); (A.Y.); (M.F.); (S.S.); (T.N.)
| | - Tomoko Ohshima
- Department of Oral Microbiology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi ku, Yokohama 230-8501, Japan; (T.O.); (T.K.)
| | - Tomomi Kawai
- Department of Oral Microbiology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi ku, Yokohama 230-8501, Japan; (T.O.); (T.K.)
| | - Takatoshi Nagano
- Department of Periodontology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi ku, Yokohama 230-8501, Japan; (Y.M.); (A.Y.); (M.F.); (S.S.); (T.N.)
| | - Kazuhiro Gomi
- Department of Periodontology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi ku, Yokohama 230-8501, Japan; (Y.M.); (A.Y.); (M.F.); (S.S.); (T.N.)
| |
Collapse
|
11
|
Mallineni S, Nagarakanti S, Gunupati S, Bv RR, Shaik MV, Chava VK. Clinical and microbiological effects of adjunctive photodynamic diode laser therapy in the treatment of chronic periodontitis: A randomized clinical trial. J Dent Res Dent Clin Dent Prospects 2021; 14:191-197. [PMID: 33408826 PMCID: PMC7770395 DOI: 10.34172/joddd.2020.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 02/08/2020] [Indexed: 11/18/2022] Open
Abstract
Background. Conventional mechanical debridement alone cannot eliminate bacteria and their products from periodontal pockets. Adjunctive therapies improve tissue healing through detoxification and bactericidal effects. Photodynamic therapy (PDT) is a non-invasive treatment procedure that involves the use of a dye as a photosensitizer to attach to the target cell and be activated by a photon of an appropriate wavelength. This study aimed to assess the effectiveness of PDT in treating periodontitis as an adjunct to scaling and root planing.
Methods. Fifteen subjects with chronic periodontitis were treated randomly with scaling and root planing (SRP), followed by a single PDT (test) or SRP (control) episode alone. Full-mouth plaque index (PI), sulcus bleeding index (SBI), probing depth (PD), and clinical attachment level (CAL) were assessed at baseline and 1-month and 3-month intervals. Microbiological evaluation of Porphyromonas gingivalis (Pg) in subgingival plaque samples was performed using a commercially available real-time polymerase chain reaction.
Results. The results revealed a significant difference in PI, SBI, PD, CAL, and microbiological parameters between the groups one and three months after treatment.
Conclusion. A combination of PDT and SRP gave rise to a significant improvement in clinical and microbiological parameters in patients with chronic periodontitis.
Collapse
Affiliation(s)
- Sahana Mallineni
- Department of Periodontology, Narayana Dental College & Hospital, Nellore, India
| | | | - Sumanth Gunupati
- Department of Periodontology, Narayana Dental College & Hospital, Nellore, India
| | - Ramesh Reddy Bv
- Department of Periodontology, Narayana Dental College & Hospital, Nellore, India
| | - Mahaboob V Shaik
- Department of Genetics, Advanced Research Centre, Narayana Medical College & Hospital, Nellore, India
| | - Vijay K Chava
- Department of Periodontology, Narayana Dental College & Hospital, Nellore, India
| |
Collapse
|
12
|
Zhao P, Song X, Nie L, Wang Q, Zhang P, Ding Y, Wang Q. Efficacy of adjunctive photodynamic therapy and lasers in the non-surgical periodontal treatment: A Bayesian network meta-analysis. Photodiagnosis Photodyn Ther 2020; 32:101969. [DOI: 10.1016/j.pdpdt.2020.101969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 01/13/2023]
|
13
|
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:pharmaceutics12111086. [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] [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.
Collapse
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;
- Correspondence:
| |
Collapse
|
14
|
Coluzzi D, Anagnostaki E, Mylona V, Parker S, Lynch E. Do Lasers Have an Adjunctive Role in Initial Non-Surgical Periodontal Therapy? A Systematic Review. Dent J (Basel) 2020; 8:dj8030093. [PMID: 32824321 PMCID: PMC7558016 DOI: 10.3390/dj8030093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/31/2022] Open
Abstract
(1) Background: dental lasers have numerous applications for periodontal therapy which include surgical procedures of soft tissue and osseous structures, and non-surgical treatments such as pathogen reduction, removal of surface accretions, and photobiomodulation. The aim of this review was to evaluate the scientific literature to ascertain whether lasers have a beneficial role when used adjunctively in initial non-surgical periodontal therapy. (2) Methods: A PubMed search was performed specifically for randomized clinical trials where a dental laser was used adjunctively for initial periodontal therapy on human patients published from January 2010–April 2020. The first search identified 1294 eligible studies. After additional criteria and filters were applied, 20 manuscripts were included in this review. (3) Results: The chosen manuscripts reported on investigations into initial therapy for patients diagnosed with chronic periodontitis. After periodontal charting, conventional instrumentation such as hand and ultrasonic scaling was performed on all patients in the studies, and then a test group or groups of patients were treated adjunctively with a laser. That adjunctive laser group’s periodontal findings showed various degrees of improved health compared to the group treated with only conventional methods. (4) Conclusion: This systematic review found that 70% of the included studies reported significantly better outcomes in certain clinical parameters, but no improvement in others. The remaining 30% of the manuscripts reported no significant difference in any of the measurements. With consideration to correct parametry, lasers have an adjunctive role in initial non-surgical periodontal therapy.
Collapse
Affiliation(s)
- Donald Coluzzi
- School of Dentistry, University of California, San Francisco, CA 94143, USA
- Correspondence:
| | - Eugenia Anagnostaki
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (E.A.); (V.M.); (S.P.); (E.L.)
| | - Valina Mylona
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (E.A.); (V.M.); (S.P.); (E.L.)
| | - Steven Parker
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (E.A.); (V.M.); (S.P.); (E.L.)
| | - Edward Lynch
- Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK; (E.A.); (V.M.); (S.P.); (E.L.)
- School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, NV 89106, USA
| |
Collapse
|
15
|
Zhang K, Li X, Yu C, Wang Y. Promising Therapeutic Strategies Against Microbial Biofilm Challenges. Front Cell Infect Microbiol 2020; 10:359. [PMID: 32850471 PMCID: PMC7399198 DOI: 10.3389/fcimb.2020.00359] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/10/2020] [Indexed: 12/17/2022] Open
Abstract
Biofilms are communities of microorganisms that are attached to a biological or abiotic surface and are surrounded by a self-produced extracellular matrix. Cells within a biofilm have intrinsic characteristics that are different from those of planktonic cells. Biofilm resistance to antimicrobial agents has drawn increasing attention. It is well-known that medical device- and tissue-associated biofilms may be the leading cause for the failure of antibiotic treatments and can cause many chronic infections. The eradication of biofilms is very challenging. Many researchers are working to address biofilm-related infections, and some novel strategies have been developed and identified as being effective and promising. Nevertheless, more preclinical studies and well-designed multicenter clinical trials are critically needed to evaluate the prospects of these strategies. Here, we review information about the mechanisms underlying the drug resistance of biofilms and discuss recent progress in alternative therapies and promising strategies against microbial biofilms. We also summarize the strengths and weaknesses of these strategies in detail.
Collapse
Affiliation(s)
- Kaiyu Zhang
- Department of Infectious Diseases, First Hospital of Jilin University, Changchun, China
| | - Xin Li
- Department of Infectious Diseases, First Hospital of Jilin University, Changchun, China
| | - Chen Yu
- Department of Infectious Diseases, First Hospital of Jilin University, Changchun, China
| | - Yang Wang
- Department of Infectious Diseases, First Hospital of Jilin University, Changchun, China.,Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| |
Collapse
|
16
|
Reis MBL, Mandetta CDMR, Dantas CDF, Marañón-Vásquez G, Taba M, de Souza SLS, Messora MR, Bulle DBP, Novaes AB. Root coverage of gingival recessions with non-carious cervical lesions: a controlled clinical trial. Clin Oral Investig 2020; 24:4583-4589. [PMID: 32440936 DOI: 10.1007/s00784-020-03325-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 05/01/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The non-carious cervical lesion (NCCL) is commonly produced by improper toothbrushing techniques, occlusion trauma, anatomic mal-positioned teeth, and acid erosion, thus sharing the same etiology of gingival recession (GR). The association of a graft to the coronally advanced flap had demonstrated the best long-term outcome for root coverage (RC). However, substitutes for the autogenous graft must be studied. This split-mouth clinical trial investigates the RC and the increase in keratinized tissue (KT) when comparing RC of NCCLs associated with GR with intact roots using an extended coronally advanced flap (ECAF) associated with the acellular dermal matrix graft (ADMG), a connective tissue replacement graft. MATERIAL AND METHODS Seventeen individuals with bilateral GR were included in the study. One side had a NCCL (TG) and the opposite root was intact (CG). All patients were treated with the ECDF associated with ADMG. All clinical parameters were assessed at baseline and 6 months postoperative. RESULTS Root coverage means (CG, 69.5 ± 19 and TG. 72.2 ± 16.5; p value = 0.849570) were not significantly different between control and test groups. In addition, the KT had an increase in the follow-up period for both groups. CONCLUSION GR associated with NCCLs can be successfully treated with the ECDF and ADMG. CLINICAL RELEVANCE Patients frequently search for GR treatment due to cervical wear, root sensitivity, and compromising aesthetics. The NCCL participates with the same issues. The present study contributes to the literature that GR associated with NCCLs can be successfully treated with the ECAF and the ADMG.
Collapse
Affiliation(s)
- Marilia Bianchini Lemos Reis
- Department of Oral & Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental School, University of São Paulo - USP, Avenida do Café, s/n - FORP-USP, Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Carolina de Moraes Rego Mandetta
- Department of Oral & Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental School, University of São Paulo - USP, Avenida do Café, s/n - FORP-USP, Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Carolina Delmondes Freitas Dantas
- Department of Oral & Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental School, University of São Paulo - USP, Avenida do Café, s/n - FORP-USP, Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Guido Marañón-Vásquez
- Department of Oral & Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental School, University of São Paulo - USP, Avenida do Café, s/n - FORP-USP, Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Mario Taba
- Department of Oral & Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental School, University of São Paulo - USP, Avenida do Café, s/n - FORP-USP, Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Sergio Luis Scombatti de Souza
- Department of Oral & Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental School, University of São Paulo - USP, Avenida do Café, s/n - FORP-USP, Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Michel Reis Messora
- Department of Oral & Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental School, University of São Paulo - USP, Avenida do Café, s/n - FORP-USP, Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Daniela Bazan Palioto Bulle
- Department of Oral & Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental School, University of São Paulo - USP, Avenida do Café, s/n - FORP-USP, Ribeirão Preto, 14040-904, São Paulo, Brazil
| | - Arthur Belém Novaes
- Department of Oral & Maxillofacial Surgery and Periodontology, Ribeirão Preto Dental School, University of São Paulo - USP, Avenida do Café, s/n - FORP-USP, Ribeirão Preto, 14040-904, São Paulo, Brazil.
| |
Collapse
|
17
|
Sena IADA, Silva DNDA, Azevedo MLDS, da Silva NT, Longo JPF, de Moraes M, de Aquino Martins ARL. Antimicrobial Photodynamic Therapy Using a Chloro-Aluminum Phthalocyanine Adjuvant to Nonsurgical Periodontal Treatment Does Not Improve Clinical Parameters in Patients with Chronic Periodontitis. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:729-735. [PMID: 31589587 DOI: 10.1089/photob.2019.4651] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background and objective: To evaluate the effects of antimicrobial photodynamic therapy (aPDT) with chloro-aluminum phthalocyanine (AlClFc) adjuvant to scaling and root planing (SRP) on periodontal clinical parameters of patients with chronic periodontitis. Materials and methods: Fifty-four periodontal sites were randomly distributed into two groups: 27 in the test group (SRP+aPDT)-using a low-power laser application Photon Lase III (DMC Equipamentos Ltda, São Carlos, São Paulo, Brazil) with operational parameters of 660 nm and 100 mW for 15 sec, and 27 in the control group (SRP). SRP was performed in a single session and the periodontal clinical parameters such as visible plaque index, bleeding on probing (BOP), probing depth (PD), and clinical attachment level were assessed at the baseline (T0) and 3 months after aPDT (T3). Results: Regarding BOP, a decrease in both treatment groups, the test group (p = 0.003) and control group (p = 0.001), was reported between T0 and T3. A reduction in PD and clinical insertion gain for both treatment groups (p < 0.05) after 3 months of therapy was observed, although nonsignificant (p > 0.05) in intergroup comparison. Conclusions: aPDT with AlClFc adjuvant to SRP did not provide additional benefits in reducing PD and clinical insertion gain.
Collapse
Affiliation(s)
| | | | | | | | - João Paulo Figueiró Longo
- Department of Genetics and Morphology, Institute of Biological Sciences, University of Brasília, Brasília/DF, Brazil
| | - Maiara de Moraes
- Department of Health Sciences, Center for Biological and Health Sciences, Medicine, Rural Federal University of Semi-Árido (UFERSA), Mossoró, Rio Grande do Norte, Brazil
| | | |
Collapse
|
18
|
J.H. Martinez C, Villafuerte KR, Luchiari HR, O. Cruz J, Sales M, Palioto DB, Messora MR, Souza SL, Taba M, Ramos ES, Novaes AB. Effect of smoking on the DNA methylation pattern of the SOCS1 promoter in epithelial cells from the saliva of patients with chronic periodontitis. J Periodontol 2019; 90:1279-1286. [DOI: 10.1002/jper.18-0692] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/24/2019] [Accepted: 02/24/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Cristhiam J.H. Martinez
- Department of Oral & Maxillofacial Surgery, and PeriodontologySchool of Dentistry of Ribeirão PretoUniversity of São Paulo Ribeirão Preto SP Brazil
| | - Kelly R.V. Villafuerte
- Department of Oral & Maxillofacial Surgery, and PeriodontologySchool of Dentistry of Ribeirão PretoUniversity of São Paulo Ribeirão Preto SP Brazil
| | - Heloise R. Luchiari
- Laboratory of Epigenetics and ReproductionDepartment of GeneticsRibeirão Preto Medical SchoolUniversity of São Paulo Ribeirão Preto SP Brazil
| | - Juliana O. Cruz
- Laboratory of Epigenetics and ReproductionDepartment of GeneticsRibeirão Preto Medical SchoolUniversity of São Paulo Ribeirão Preto SP Brazil
| | - Mariana Sales
- Department of Oral & Maxillofacial Surgery, and PeriodontologySchool of Dentistry of Ribeirão PretoUniversity of São Paulo Ribeirão Preto SP Brazil
| | - Daniela B. Palioto
- Department of Oral & Maxillofacial Surgery, and PeriodontologySchool of Dentistry of Ribeirão PretoUniversity of São Paulo Ribeirão Preto SP Brazil
| | - Michel R. Messora
- Department of Oral & Maxillofacial Surgery, and PeriodontologySchool of Dentistry of Ribeirão PretoUniversity of São Paulo Ribeirão Preto SP Brazil
| | - Sergio L.S. Souza
- Department of Oral & Maxillofacial Surgery, and PeriodontologySchool of Dentistry of Ribeirão PretoUniversity of São Paulo Ribeirão Preto SP Brazil
| | - Mario Taba
- Department of Oral & Maxillofacial Surgery, and PeriodontologySchool of Dentistry of Ribeirão PretoUniversity of São Paulo Ribeirão Preto SP Brazil
| | - Ester S. Ramos
- Laboratory of Epigenetics and ReproductionDepartment of GeneticsRibeirão Preto Medical SchoolUniversity of São Paulo Ribeirão Preto SP Brazil
| | - Arthur B. Novaes
- Department of Oral & Maxillofacial Surgery, and PeriodontologySchool of Dentistry of Ribeirão PretoUniversity of São Paulo Ribeirão Preto SP Brazil
| |
Collapse
|
19
|
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.
Collapse
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.
| |
Collapse
|
20
|
Antimicrobial photodynamic therapy as adjunct to non-surgical periodontal treatment in smokers: a randomized clinical trial. Clin Oral Investig 2018; 23:3173-3182. [DOI: 10.1007/s00784-018-2740-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 10/25/2018] [Indexed: 02/01/2023]
|
21
|
Raut CP, Sethi KS, Kohale BR, Mamajiwala A, Warang A. Indocyanine green-mediated photothermal therapy in treatment of chronic periodontitis: A clinico-microbiological study. J Indian Soc Periodontol 2018; 22:221-227. [PMID: 29962701 PMCID: PMC6009169 DOI: 10.4103/jisp.jisp_128_18] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: Photodynamic therapy (PDT) has developed as an alternative treatment modality in periodontitis patients. Different photosensitizers used over the years have shown contradictory results. Thus, recently indocyanine green (ICG)-mediated photothermal therapy has emerged for the treatment of chronic periodontitis. Aim: The present study aimed at comparing and evaluating the effects of photothermal therapy using ICG in the treatment of chronic periodontitis with scaling and root planing (SRP). Materials and Methods: This was a randomized, controlled, clinical trial where fifty participants were equally divided into two groups, i.e., control group (SRP) and test group (SRP + photothermal therapy). Clinical parameters were evaluated at baseline and 6-month follow-up. These were plaque index (PI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL). Microbiological analysis of plaque sample was also done to check for anaerobic mixed flora. Results: Significant reduction was seen in PD, CAL, and BOP in the test group as compared to control group after 6 months (P < 0.05). However, intergroup comparison of PI showed nonsignificant results (P > 0.05). Anaerobic culture of plaque samples of test group also revealed a significant reduction of microorganisms in comparison with control group. Conclusion: ICG-mediated photothermal therapy can act as an alternative to antimicrobial PDT as an adjunct to SRP in the treatment of chronic periodontitis.
Collapse
Affiliation(s)
- Chetan Purushottam Raut
- Department of Periodontology, MGV KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Kunal Sunder Sethi
- Department of Periodontology, MGV KBH Dental College and Hospital, Nashik, Maharashtra, India
| | | | - Alefiya Mamajiwala
- Department of Periodontology, MGV KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Ayushya Warang
- Department of Periodontology, MGV KBH Dental College and Hospital, Nashik, Maharashtra, India
| |
Collapse
|
22
|
Azaripour A, Dittrich S, Van Noorden CJF, Willershausen B. Efficacy of photodynamic therapy as adjunct treatment of chronic periodontitis: a systematic review and meta-analysis. Lasers Med Sci 2017; 33:407-423. [DOI: 10.1007/s10103-017-2383-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 11/06/2017] [Indexed: 01/19/2023]
|
23
|
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.
Collapse
|
24
|
Nagai Y, Suzuki A, Katsuragi H, Shinkai K. Effect of antimicrobial photodynamic therapy (aPDT) on the sterilization of infected dentin in vitro. Odontology 2017; 106:154-161. [PMID: 29071451 DOI: 10.1007/s10266-017-0321-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/09/2017] [Indexed: 10/18/2022]
Abstract
The aim of this study was to evaluate the bactericidal effect of antimicrobial photodynamic therapy (aPDT) on an infected dentin model. Dentin plates were prepared from extracted human molars and infected through immersion in a solution of Streptococcus mutans. The nine experimental groups consisted of two laser irradiation groups (650 nm laser: 650 laser and 940 nm laser: 940 laser), two photosensitizer groups (methylene blue: MB, and azulenocyanine: Azc), four aPDT groups (650 nm laser irradiation of MB: 650 laser-MB, 650 nm laser irradiation of Azc: 650 laser-Azc, 940 nm laser irradiation of MB: 940 laser-MB and 940 nm laser irradiation of Azc: 940 laser-Azc) and a control. The bactericidal effects on each group were evaluated by colony count and adenosine triphosphate (ATP) assays. Based on the results of the colony count assay, the 650 laser-MB and 940 laser-MB groups formed significantly fewer colonies than the other experimental groups. Significantly fewer colonies were observed in the 940 laser-Azc group than in the control, but significant differences in the numbers of colonies were not observed between the 650 laser-Azc and control groups. The 940 laser group formed slightly fewer colonies than the 650 laser group, but the difference was not significant. In addition, the number of colonies in the MB group was significantly less than the number in the Azc group. The results of the ATP assay were similar to those of the colony count assay. aPDT with MB showed a significant bactericidal effect on dentin plates infected with S. mutans.
Collapse
Affiliation(s)
- Yuta Nagai
- Advanced Operative Dentistry-Endodontics, The Nippon Dental University Graduate School of Life Dentistry at Niigata, Niigata, Japan
| | - Anri Suzuki
- Department of Microbiology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Hiroaki Katsuragi
- Department of Microbiology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Koichi Shinkai
- Department of Operative Dentistry, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamaura-cho, Chuo-ku, Niigata, 951-8580, Japan.
| |
Collapse
|
25
|
Segarra-Vidal M, Guerra-Ojeda S, Vallés LS, López-Roldán A, Mauricio MD, Aldasoro M, Alpiste-Illueca F, Vila JM. Effects of photodynamic therapy in periodontal treatment: A randomized, controlled clinical trial. J Clin Periodontol 2017; 44:915-925. [PMID: 28667678 DOI: 10.1111/jcpe.12768] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2017] [Indexed: 01/06/2023]
Abstract
AIM To evaluate the effects of photodynamic therapy (PDT) in the nonsurgical treatment of chronic periodontitis. MATERIALS AND METHODS A randomized, single-blind, controlled, parallel-group clinical trial was performed. Sixty patients were enrolled: 20 healthy controls and 40 patients with periodontitis. The 40 patients were randomized for scaling and root planing (SRP) or SRP + PDT. Periodontal (plaque index, probing depth, clinical recession, clinical attachment level, bleeding on probing and gingival crevicular fluid volume, corresponding to 381 versus 428 critical sites), microbiological (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia and Campylobacter rectus presence, 18 versus 19 samples) and biochemical (interleukin (IL)-1β, IL-6 and tumour necrosis factor (TNF)-α, receptor activator of nuclear factor-kappaB ligand (RANK-L) and osteoprotegerin (OPG) levels, 18 versus 19 samples) parameters were recorded. RESULTS Within each group, significant improvements were found for clinical parameters, though without significant differences between groups. RANK-L was significantly decreased at week 13 in the SRP + PDT group compared with the SRP group. SRP + PDT, but not SRP alone, significantly reduced the abundance of A. actinomycetemcomitans. CONCLUSIONS Except for a significant decrease in the pathogenic burden of A. actinomycetemcomitans, coadjuvant PDT resulted in no additional improvement compared with SRP alone in patients diagnosed with moderate-to-advanced chronic periodontitis.
Collapse
Affiliation(s)
- Marta Segarra-Vidal
- Department of Stomatology, School of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Sol Guerra-Ojeda
- Department of Physiology, School of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Lilian Soraya Vallés
- Department of Physiology, School of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Andrés López-Roldán
- Department of Stomatology, School of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - María Dolores Mauricio
- Department of Physiology, School of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Martín Aldasoro
- Department of Physiology, School of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Francisco Alpiste-Illueca
- Department of Stomatology, School of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Jose María Vila
- Department of Physiology, School of Medicine and Dentistry, University of Valencia, Valencia, Spain
| |
Collapse
|
26
|
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]
|
27
|
Xue D, Tang L, Bai Y, Ding Q, Wang P, Zhao Y. Clinical efficacy of photodynamic therapy adjunctive to scaling and root planing in the treatment of chronic periodontitis: A systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2017; 18:119-127. [PMID: 28188919 DOI: 10.1016/j.pdpdt.2017.01.183] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/07/2016] [Accepted: 01/29/2017] [Indexed: 01/10/2023]
Abstract
PURPOSE To evaluate the clinical efficacy of photodynamic therapy (PDT) adjunctive to scaling and root planing (SRP) in patients with untreated chronic periodontitis based on up-to-date evidence. METHODS MEDLINE and the Cochrane Library were systematically searched to identify eligible randomized controlled trials (RCTs), supplemented by a manual literature search. Mean differences (MD) and the corresponding 95% confidence intervals (CI) of probing depth (PD) reduction and clinical attachment level (CAL) gain were synthesized. The I2 test and Q statistics were used to determine the inter-study heterogeneity. Subgroup analysis based on smoking status was performed. RESULTS Eleven RCTs with a total of 243 subjects were included. Significant improvement in PD reduction (MD=0.13, CI:0.02-0.24, p=0.02) and marginal significant improvement in CAL gain (MD=0.18, CI:-0.005-0.363, p=0.056) were observed in favor of SRP+PDT at 3months. When evaluated at 6months after baseline, the association of PDT with SRP resulted in a significant benefit in PD reduction (MD=0.40, CI:0.05-0.74, p=0.03), but not in CAL gain (MD=0.37, CI:-0.18-0.93, p=0.18). Subgroup analysis revealed that the combined therapy produced no significant improvements in PD and CAL at neither 3months nor 6months for studies with smokers. No treatment-related adverse events or side effects had been reported by the included studies. CONCLUSIONS Pooled analysis suggests a short-term benefit of PDT as an adjunct to SRP in clinical outcome variables. However, evidence regarding its long-term efficacy is still insufficient and no significant effect has been confirmed in terms of CAL gain at 6months. Future clinical trials of high methodological quality are needed to establish the optimal combination of photosensitizer and laser configuration.
Collapse
Affiliation(s)
- Dong Xue
- Department of Stomatology, Capital Medical University Xuanwu Hospital,No. 45 Changchun Street, West District, Beijing, China
| | - Lu Tang
- Department of Stomatology, Capital Medical University Xuanwu Hospital,No. 45 Changchun Street, West District, Beijing, China
| | - Yuhao Bai
- Department of Stomatology, Capital Medical University Xuanwu Hospital,No. 45 Changchun Street, West District, Beijing, China
| | - Qian Ding
- Department of Stomatology, Capital Medical University Xuanwu Hospital,No. 45 Changchun Street, West District, Beijing, China
| | - Pengcheng Wang
- Department of Stomatology, Capital Medical University Xuanwu Hospital,No. 45 Changchun Street, West District, Beijing, China
| | - Ying Zhao
- Department of Stomatology, Capital Medical University Xuanwu Hospital,No. 45 Changchun Street, West District, Beijing, China.
| |
Collapse
|
28
|
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.
Collapse
|
29
|
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.
Collapse
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
| |
Collapse
|
30
|
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]
|
31
|
Birang R, Shahaboui M, Kiani S, Shadmehr E, Naghsh N. Effect of Nonsurgical Periodontal Treatment Combined With Diode Laser or Photodynamic Therapy on Chronic Periodontitis: A Randomized Controlled Split-Mouth Clinical Trial. J Lasers Med Sci 2015; 6:112-9. [PMID: 26464778 DOI: 10.15171/jlms.2015.04] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION The optimum removal of bacteria and their toxins from periodontal pockets is not always obtained by conventional mechanical debridement. Adjunctive therapies may improve tissue healing through detoxification and bactericidal effects. The purpose of the present study was to evaluate the impact of adjunctive laser therapy (LT) and photodynamic therapy (PDT) on patients with chronic periodontitis. METHODS Twenty patients with at least three quadrants involved and each of them presenting pockets 4-8 mm deep were included in the study. Periodontal treatment comprising scaling and root planning (SRP) was accomplished for the whole mouth. Applying a split-mouth design, each quadrant was randomly treated with SRP alone (group A), SRP with LT (group B), and SRP with PDT (group C). The clinical indices were measured at baseline 6 weeks and 3 months after treatment. Microbiological samples were taken and evaluated at baseline and 3-month follow-up. RESULTS All groups showed statistically significant improvements in terms of clinical attachment level (CAL) gain, periodontal pocket depth (PPD) reduction, papilla bleeding index and microbial count compared to baseline (P < .05). The results showed more significant improvement in the 6-week evaluation in terms of CAL in groups B and C than in group A (P < .05). Group B also revealed a greater reduction in PPD than the other treatment modalities (P < .05). CONCLUSION The obtained data suggested that adjunctive LT and PDT have significant short-term benefits in the treatment of chronic periodontitis. Furthermore, LT showed minimal additional advantages compared to PDT.
Collapse
Affiliation(s)
- Reza Birang
- Department of Periodontology, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Shahaboui
- Department of Periodontology, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sima Kiani
- Department of Periodontology, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Shadmehr
- Department of Endodontics, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Narges Naghsh
- Department of Periodontology, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
32
|
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]
|
33
|
Dilsiz A, Sevinc S. Trauma from instrumentation after non-surgical periodontal treatment with ultrasonic scalers and Nd:YAG laser. Acta Odontol Scand 2015; 73:144-9. [PMID: 25252593 DOI: 10.3109/00016357.2014.961955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Periodontal therapies aimed at altering the progression of periodontal diseases must include meticulous mechanical debridement during both the non-surgical and the surgical phases of periodontal treatment. The aim of this study was to evaluate and compare the immediate effect of trauma from instrumentation on clinical attachment level after non-surgical periodontal treatment with ultrasonic scalers and a Nd:YAG laser. MATERIALS AND METHODS Twenty-four patients with untreated chronic periodontitis, presenting probing depths of 4-6 mm on anterior teeth, upper and lower, were entered into the study. The selected teeth were probed with a pressure-controlled probe, guided by stents. Each quadrant was randomly allocated in a split-mouth design either to treatment with Nd:YAG laser using an energy of 1W, 100mj, 1064nm (test group) or to periodontal treatment using ultrasonic scalers (control group). Clinical parameters, including plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD) and probing attachment level (PAL) were acquired prior to and immediately after treatment. RESULTS Statistical analysis demonstrated no differences between groups at baseline for all parameters (p > 0.05). Immediately after treatment, the control group showed a greater PAL loss than the test group (p < 0.05). For the control group, there were statistically significant differences between PAL immediately before and after treatment (p < 0.05), but not test group (p > 0.05). CONCLUSIONS Within the limits of the present study, it may be concluded that non-surgical periodontal treatment with ultrasonic scalers causes a mean immediate attachment loss of 0.68 mm and that a Nd:YAG laser seems to reduce significantly the trauma the instrumentation produced.
Collapse
Affiliation(s)
- Alparslan Dilsiz
- Department of Periodontology, Faculty of Dentistry, Atatürk University , Erzurum , Turkey
| | | |
Collapse
|
34
|
Lopes RG, de Godoy CHL, Deana AM, de Santi MESO, Prates RA, França CM, Fernandes KPS, Mesquita-Ferrari RA, Bussadori SK. Photodynamic therapy as a novel treatment for halitosis in adolescents: study protocol for a randomized controlled trial. Trials 2014; 15:443. [PMID: 25394474 PMCID: PMC4236439 DOI: 10.1186/1745-6215-15-443] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 10/07/2014] [Indexed: 12/25/2022] Open
Abstract
Background Halitosis is a common problem that affects a large portion of the population worldwide. The origin of this condition is oral in 90% and systemic in 10% of cases. The unpleasant odor is mainly the result of volatile sulfur compounds produced by Gram-negative bacteria. However, it has recently been found that anaerobic Gram-positive bacteria also produce hydrogen sulfide (H2S) in the presence of amino acids, such as cysteine. Light, both with and without the use of chemical agents, has been used to induce therapeutic and antimicrobial effects. In photodynamic therapy, the antimicrobial effect is confined to areas covered by photosensitizing dye. The aim of the present study is to evaluate the antimicrobial effect of photodynamic therapy on halitosis in adolescents through the analysis of volatile sulfur compounds measured using gas chromatography and microbiological analysis of coated tongue. Methods/Design A quantitative clinical trial will be carried out involving 60 adolescents randomly divided into the following groups: group 1 will receive treatment with a tongue scraper, group 2 will receive photodynamic therapy applied to the posterior two-thirds of the dorsum of the tongue, and group 3 will receive combined treatment (tongue scraper and photodynamic therapy). Gas chromatography (OralChromaTM) and microbiological analysis will be used for the diagnosis of halitosis at the beginning of the study. Post-treatment evaluations will be conducted at one hour and 24 hours after treatment. The statistical analysis will include the Shapiro-Wilk test for the determination of the distribution of the data. If normal distribution is demonstrated, analysis of variance followed by Tukey’s test will be used to compare groups. The Kruskal-Wallis test followed by the Student-Newman-Keuls test will be used for data with non-normal distribution. Either the paired t-test or the Wilcoxon test will be used to compare data before and after treatment, depending on the distribution of the data. Discussion The results of this trial will determine the efficacy of using photodynamic therapy alone or in combination with a tongue scraper to treat bad breath in adolescents. Trial registration The protocol for this study was registered with Clinical Trials (registration number NCT02007993) on 10 December 2013.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Sandra Kalil Bussadori
- University Nove de Julho, Rua Vergueiro, 235, Liberdade, São Paulo, SP 01504-000, Brazil.
| |
Collapse
|
35
|
Dilsiz A, Sevinc S. KTP laser therapy as an adjunctive to scaling and root planing in treatment of chronic periodontitis. Acta Odontol Scand 2014; 72:681-6. [PMID: 24646100 DOI: 10.3109/00016357.2014.898088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The main goal of periodontal treatment is to control infection and, thereby, curb disease progression. Recent studies have suggested that the use of a laser as an adjunct to scaling and root planing (SRP) might improve the effectiveness of conventional periodontal treatment. The aim of this study was to evaluate and compare the clinical effects of potassium-titanyl-phosphate (KTP) laser therapy in the treatment of chronic periodontitis in combination with traditional SRP. MATERIALS AND METHODS Twenty-four patients with untreated chronic periodontitis were treated using a split-mouth study design in which each side was randomly treated by SRP alone (control group) or KTP laser (0.8W, time on 50 ms, time off 50 ms, 30 s, 532 nm) followed by SRP (test group). In the distribution of the teeth (total = 124 teeth) in the patients, 106 (86%) were molars and 18 (14%) were premolars. The selected teeth were probed with a pressure-controlled probe, guided by stents. Clinical periodontal parameters including plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD) and probing attachment level (PAL) were recorded at baseline and at 2 and 12 months following therapy. RESULTS Statistical analysis demonstrated no differences between groups at baseline for all parameters (p > 0.05). BOP and PPD reductions and PAL gains were statistically significant both between baseline and 2 months and between baseline and 12 months in both groups (p < 0.05). The test group showed a greater reduction in PPD compared to the control group (p < 0.05). In addition, the test group showed a greater probing attachment gain compared to the control group (p < 0.05). CONCLUSIONS In patients with chronic periodontitis, clinical outcomes of conventional periodontal treatment can be improved by using an adjunctive KTP laser.
Collapse
Affiliation(s)
- Alparslan Dilsiz
- Department of Periodontology, Faculty of Dentistry, Atatürk University , Erzurum , Turkey
| | | |
Collapse
|
36
|
Javed F, Romanos GE. Does Photodynamic Therapy Enhance Standard Antibacterial Therapy in Dentistry? Photomed Laser Surg 2013; 31:512-8. [DOI: 10.1089/pho.2012.3329] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Fawad Javed
- Eng. A.B. Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Laboratory, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Georgios E. Romanos
- Department of Dental Medicine, School of Dental Medicine, Stony Brook University, Stony Brook, New York
| |
Collapse
|
37
|
Sgolastra F, Petrucci A, Severino M, Graziani F, Gatto R, Monaco A. Adjunctive photodynamic therapy to non-surgical treatment of chronic periodontitis: a systematic review and meta-analysis. J Clin Periodontol 2013; 40:514-26. [PMID: 23557433 DOI: 10.1111/jcpe.12094] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2013] [Indexed: 01/16/2023]
Abstract
AIM To investigate the efficacy of antimicrobial photodynamic therapy (aPDT) adjunctive to scaling root planing (SRP) in patients with chronic periodontitis. METHODS A meta-analysis was conducted according to the PRISMA statement and Cochrane Collaboration recommendations. Two independent reviewers performed an extensive literature search and manual search on seven databases. Mean differences (MD) and 95% confidence intervals (CI) were calculated for clinical attachment level (CAL) gain and probing depth (PD) reduction. The I(2) test was used for inter-study heterogeneity. Publication bias was examined by Egger's regression test and the trim-and-fill method. RESULTS Sensitivity analysis of 14 randomized clinical trials (RCTs) revealed differences in PD reduction (MD 0.19, 95% CI 0.07-0.31, p = 0.002) and CAL gain (MD 0.37, 95% CI 0.26-0.47, p < 0.0001) in favour of SRP + aPDT, with no evidence of heterogeneity. Subgroup analysis revealed the absence of heterogeneity in RCTs, with high risk of bias for PD reduction and CAL gain. No evidence of publication bias was detected. CONCLUSIONS The use of adjunctive aPDT to conventional SRP provides short-term benefits. The evidence to support its clinical medium/long-term efficacy is insufficient. Further high-quality RCTs are needed to investigate the influence of potential confounders on the efficacy of adjunctive aPDT.
Collapse
Affiliation(s)
- Fabrizio Sgolastra
- Department of Life, Health, and Environmental Sciences, School of Dentistry, University of L'Aquila, L'Aquila, Italy.
| | | | | | | | | | | |
Collapse
|