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Nedumaran N, Rajasekar A. Efficacy of Rose Bengal-Mediated Antimicrobial Photodynamic Therapy as an Adjunct to Scaling and Root Planing on Clinical and Microbiological Parameters in the Management of Chronic Periodontitis: A Single-Blinded, Randomized Controlled Clinical Trial. Photobiomodul Photomed Laser Surg 2024. [PMID: 39007179 DOI: 10.1089/pho.2024.0037] [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: 07/16/2024] Open
Abstract
Aim: The study aims to assess the efficacy of rose bengal (RB)-mediated antimicrobial photodynamic therapy (a-PDT) as an adjunct to scaling and root planing in the management of chronic periodontitis patients in terms of clinical parameters like gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and microbiological parameters like total microbial count, total red complex organism count, Porphyromonas gingivalis count, Treponema denticola count, and Tannerella forsythia count. Materials and Methods: In this randomized controlled clinical trial, a total of 30 patients were recruited who met the inclusion criteria. The participants were randomly allocated into group A with scaling and root planning (SRP) alone and group B with SRP + a-PDT. The clinical and microbiological parameters were measured at baseline and at 3-month follow-up. Intergroup and intragroup comparisons were performed using independent t test and paired t test, respectively. Value of p < 0.05 was considered as statistically significant. Results: At 3-month follow-up, group B treated with SRP + a-PDT showed statistically significant reduction in GI (0.58 ± 0.20) and PPD (1.81 ± 0.32 mm), gain in CAL (0.73 ± 0.04 mm), and reduction in total microbial count [2.80 ± 0.08 × 104 colony forming unit (CFU)], total red complex count (0.29 ± 0.14 × 102 CFU), P. gingivalis count (0.43 ± 0.13 × 102 CFU), T. denticola count (0.61 ± 0.04 × 102 CFU), and T. forsythia count (0.59 ± 0.04 × 102 CFU) as compared with group A (p < 0.05). Conclusion: RB-mediated a-PDT as an adjunct to SRP was significantly more effective in improving GI, PPD, and CAL and in reducing microbial count as compared with SRP alone in the management of chronic periodontitis.
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Affiliation(s)
- Nivedha Nedumaran
- Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Arvina Rajasekar
- Department of Periodontology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
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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.
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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
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Souza DAS, de Lima Dantas JB, Souto CS, Mendonça DM, Oliveira TJS, Dos Santos Vianna Néri J. Photodynamic therapy adjuvant to non-surgical periodontal therapy: Systematic review of randomized clinical trials. Int J Dent Hyg 2024; 22:45-55. [PMID: 37752814 DOI: 10.1111/idh.12759] [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: 01/17/2022] [Revised: 08/25/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVES To systematically evaluate randomised controlled trials (RCTs) on whether adjuvant application of antimicrobial photodynamic therapy (aPDT) through the technique of irradiation in the external region of the periodontal pocket with optic-fibre tip offers benefits to scaling and root planning (SRP). METHODS Five databases were searched by two independent reviewers according to pre-specified eligibility criteria up to April 2023. No restrictions regarding date of publication, language and minimum follow-up period were imposed. The Cochrane Collaboration's Risk of Bias tool (RoB 2.0) was used for quality appraisal and Grading of Recommendations, Assessment, Development and Evaluation for assessing the certainty of evidence. RESULTS A total of 1388 publications were identified and reviewed for eligibility. Four of them fulfilled the inclusion criteria. The sample consisted of a total of 83 patients with periodontitis. In these, 330 periodontal sites were evaluated. The clinical findings of the majority of the included studies demonstrated that patients who received the association of aPDT + RAR with the protocol evaluated here, obtained clinical results similar to patients who received only the SRP alone. In none of the evaluated RCTs, clinical advantages were observed that would categorise this aPDT protocol as superior to conventional treatment. CONCLUSION Applying aPDT after SRP with external irradiation of the periodontal pocket does not seem to result in any clinical benefit compared to the use of SRP alone in patients with periodontitis.
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Affiliation(s)
- Daniel Adrian Silva Souza
- Federal University of Bahia, Stricto Sensu Graduate Program in Dentistry, Salvador, Bahia, Brazil
- Dentistry Course, Adventist College of Bahia, Cachoeira, Bahia, Brazil
| | - Juliana Borges de Lima Dantas
- Dentistry Course, Adventist College of Bahia, Cachoeira, Bahia, Brazil
- Federal University of Bahia, Institute of Health Sciences, Stricto Sensu Graduate Program in Interactive Process of Organs and Systems, Salvador, Bahia, Brazil
- School of Medicine and Public Health, Salvador, Bahia, Brazil
| | | | | | - Tiago José Silva Oliveira
- Dentistry Course, Adventist College of Bahia, Cachoeira, Bahia, Brazil
- São Leopoldo Mandic Dental Research Center, Stricto Sensu Graduate Program in Dental Sciences (Implantology), São Paulo, Brazil
| | - Júlia Dos Santos Vianna Néri
- Federal University of Bahia, Stricto Sensu Graduate Program in Dentistry, Salvador, Bahia, Brazil
- Dentistry Course, Adventist College of Bahia, Cachoeira, Bahia, Brazil
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Harris DM, Sulewski JG. Photoinactivation and Photoablation of Porphyromonas gingivalis. Pathogens 2023; 12:1160. [PMID: 37764967 PMCID: PMC10535405 DOI: 10.3390/pathogens12091160] [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: 07/20/2023] [Revised: 08/31/2023] [Accepted: 09/02/2023] [Indexed: 09/29/2023] Open
Abstract
Several types of phototherapy target human pathogens and Porphyromonas gingivitis (Pg) in particular. The various approaches can be organized into five different treatment modes sorted by different power densities, interaction times, effective wavelengths and mechanisms of action. Mode 1: antimicrobial ultraviolet (aUV); mode 2: antimicrobial blue light (aBL); mode 3: antimicrobial selective photothermolysis (aSP); mode 4: antimicrobial vaporization; mode 5: antimicrobial photodynamic therapy (aPDT). This report reviews the literature to identify for each mode (a) the putative molecular mechanism of action; (b) the effective wavelength range and penetration depth; (c) selectivity; (d) in vitro outcomes; and (e) clinical trial/study outcomes as these elements apply to Porphyromonas gingivalis (Pg). The characteristics of each mode influence how each is translated into the clinic.
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Affiliation(s)
- David M. Harris
- Bio-Medical Consultants, Inc., Canandaigua, NY 14424, USA
- Department of Periodontics, Rutgers School of Dental Medicine, Newark, NJ 07103, USA
| | - John G. Sulewski
- Institute for Advanced Dental Technologies, Huntington Woods, MI 48070, USA
- Millennium Dental Technologies, Inc., Cerritos, CA 90703, USA
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Costa FO, Esteves Lima RP, Costa AM, Costa AA, Mattos Pereira GH, Cortelli SC, Cortelli JR, Magalhães Cyrino R, Aparecida Silva T, Miranda Cota LO. Adjunctive effects of photodynamic therapy using indocyanine green in residual pockets during periodontal maintenance therapy: A split-mouth randomized controlled trial. J Periodontol 2023; 94:1100-1111. [PMID: 37051740 DOI: 10.1002/jper.22-0672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/24/2023] [Accepted: 03/25/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Prospective studies have reported conflicting results regarding the adjunctive effect of antimicrobial photodynamic therapy (aPDT) on clinical and microbiological parameters in individuals under periodontal maintenance therapy (PMT). This study aimed to evaluate the clinical and microbiological adjunctive effects of aPDT using indocyanine green (ICG) in residual sites with probing depth (PD) ≥5 mm during PMT in comparison with scaling and root planing (SRP) alone. METHODS A split-mouth randomized controlled clinical trial was conducted with 24 individuals in a PMT program. Contralateral quadrants with eligible residual sites were randomly assigned to either SRP + aPDT (test group) or SRP alone (control). aPDT included ICG dye and diode laser (909 nm) performed together with SRP and repeated 15 days after. Periodontal clinical parameters, periodontal inflamed surface area (PISA) index, and subgingival biofilm samples were collected at baseline (T1), 3 (T2), and 6 months later (T3). Microbiological analyses were performed by quantitative real-time polymerase chain reaction. RESULTS Significant improvements were observed in all clinical and microbiological parameters in both groups from T1 to T3. However, no significant differences were observed regarding plaque index, PD, and clinical attachment level. Test group showed significantly greater reductions in bleeding on probing (BOP), PISA index, and Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans levels, when compared with controls. CONCLUSIONS Both treatments resulted in significant clinical periodontal improvements, but with no significant differences between groups except from inflammation parameters. aPDT using ICG resulted in significant reductions in BOP and PISA index, as well as in P. gingivalis and A. actinomycetemcomitans levels.
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Affiliation(s)
- Fernando Oliveira Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Adriana Moreira Costa
- Department of Periodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Amanda Almeida Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Sheila Cavalca Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - José Roberto Cortelli
- Department of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Renata Magalhães Cyrino
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Matumoto EK, Corrêa MG, Couso-Queiruga E, Monteiro MF, Graham Z, Braz SHG, Ribeiro FV, Pimentel SP, Cirano FR, Casati MZ. Influence of partially exposed nonabsorbable membrane for alveolar ridge preservation: A randomized controlled trial. Clin Implant Dent Relat Res 2023. [PMID: 36946359 DOI: 10.1111/cid.13202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/23/2023]
Abstract
AIM This randomized controlled trial evaluated the impact of a partially exposed non-absorbable membrane (dPTFE) in Alveolar Ridge Preservation (ARP) procedures on clinical, tomographic, immunoenzymatic, implant-related, and patient-centered outcomes. MATERIALS AND METHODS Patients with a hopeless maxillary single-rooted tooth demanding rehabilitation with implants were included. Patients were randomized into two groups: dPTFE (n = 22)-tooth extraction followed by ARP using a partially exposed dPTFE membrane; USH (n = 22)-unassisted socket healing. Clinical and tomographic analyses were performed at baseline and after 3 months. After 3 months, patients received one dental implant. Implant stability quotient was obtained following implant placement. Bone-related markers were analyzed in bone biopsies using an immunoenzymatic assay. RESULTS Greater gain in Keratinized Mucosa Width (KMW) was observed in the dPTFE (1.33 ± 0.98 mm) compared to USH (0.59 ± 0.98 mm) (Mann-Whitney test, Z = 2,28, p < 0.05). USH showed a reduction of pain/discomfort, edema, and interference with daily life from the seventh day (Friedman/Wilcoxon test, maxT = 7.48, 8.00, and 5.92, respectively, p < 0.05). dPTFE presents a reduction of edema and interference with daily life from the 7th day and pain/discomfort from the 14th day (Friedman/Wilcoxon test, maxT = 5.40, 5.26, and 4.78, respectively, p < 0.05). The dPTFE group presented higher pain/discomfort in the 35 and 42 days and higher edema from 7 to 42 days postoperatively than USH group (Mann-Whitney test, p < 0.05). No differences between groups were observed in the tomographic measures, immunoenzymatic analysis, and implant stability (p > 0.05). CONCLUSION dPTFE was superior to USH by increasing KMW gain. However, dPTFE without bone graft presented similar bone loss compared to USH. This clinical trial was not registered prior to participant recruitment and randomization (NCT04329351).
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Affiliation(s)
- Edson Ken Matumoto
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil
| | | | - Emilio Couso-Queiruga
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Zachary Graham
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | | | | | - Suzana Peres Pimentel
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil
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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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The Efficiency of Photodynamic Therapy in the Bacterial Decontamination of Periodontal Pockets and Its Impact on the Patient. Diagnostics (Basel) 2022; 12:diagnostics12123026. [PMID: 36553035 PMCID: PMC9776409 DOI: 10.3390/diagnostics12123026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
Research in the field of periodontal disease continues to focus on disease-associated microorganisms, as the microbial plaque and the host immune responses are considered to be important causative factors, that are highly responsible for the progression of this disease. The purpose of this article is to compare the reduction in the number of specific periodontopathogens in two test groups according to different therapeutic approaches in periodontal disease and to show possible differences. This article is based on a prospective clinical study involving eighteen subjects with forty-four average periodontal pockets assigned to study groups treated by two different methods, SRP and SRP followed by a single PDT application. Efficiency in removing specific bacterial species was evaluated by PCR testing, at baseline and immediately after treatment. The hypothesis that using SRP + aPDT results in an increased decontamination potential was confirmed statistically, when all five specific bacterial pathogens were investigated together. When the pathogens were considered separately, two of the five microorganisms tested were significantly lower in the SRP + PDT group (p < 0.00), and important germ counts reductions were also observed for the other three. There is also a statistically significant relation between the pain at 48 h postoperatively and the type of treatment the patients received, as resulted from the Questionnaire Form. Our results demonstrate that aPDT, as an adjunctive treatment to conservative mechanical cleaning of root surfaces at sites affected by periodontitis, represents an effective tool in terms of reducing specific periodontopathogen germs.
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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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Andere NMRB, Castro Dos Santos NC, Araújo CF, Paz HES, Shaddox LM, Casarin RCV, Santamaria MP. Open flap debridement compared to repeated applications of photodynamic therapy in the treatment of residual pockets. A randomized clinical trial. J Periodontol 2022; 93:1671-1681. [PMID: 35536044 DOI: 10.1002/jper.22-0059] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The aim of the present study was to compare repeated applications of antimicrobial photodynamic therapy (aPDT) to open flap debridement (OFD) in the treatment of residual periodontal pockets in non-furcation sites. METHODS Forty-six subjects with a diagnosis of Stage III or IV Grade C periodontitis, that had been previously treated, participated in the study. Residual pockets were divided between two groups: 1) aPDT group: received ultrasonic periodontal debridement followed by immediate application of aPDT, and repeated on1st, 2nd, 7th and 14th days; and 2) OFD group: treated by modified papilla preservation technique, where granulation tissue and visible calculus were removed with hand curettes and an ultrasonic device. Clinical, immunological and microbiological parameters were evaluated before and after treatment. RESULTS Both treatments were effective reducing clinical parameters of disease. OFD resulted in a greater mean probing pocket depths (PPD) reduction in deep pockets (p = 0.001). However, aPDT resulted in a lower occurrence of gingival recession (GR), dentin hypersensitivity and analgesic intake. Reduction in Porphyromonas gingivalis was observed in both groups. Only the OFD group had a significant reduction in Aggregatibacter actinomycetemcomitans. aPDT group had greater increase in IL-10 levels and a greater reduction of IL-1β at 14 days when compared to the OFD group (p<0.05). CONCLUSION OFD was superior in reducing PPD in deep pockets compared to the aPDT. However, OFD resulted in greater GR. Both treatments lowered P. gingivalis levels but only OFD reduced levels of A. actinomycemtemcomitans. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Naira M R B Andere
- Division of Periodontics, Institute of Science and Technology, São Paulo State University, (Unesp), São José dos Campos, São Paulo, Brazil
| | - Nídia C Castro Dos Santos
- Division of Periodontics, Institute of Science and Technology, São Paulo State University, (Unesp), São José dos Campos, São Paulo, Brazil.,Dental Research Division, Guarulhos University (UNG), Guarulhos, São Paulo, Brazil
| | - Cássia F Araújo
- Division of Periodontics, Institute of Science and Technology, São Paulo State University, (Unesp), São José dos Campos, São Paulo, Brazil
| | - Hélvis E S Paz
- Division of Periodontics, Piracicaba Dental School, University of Campinas (Unicamp), Piracicaba, São Paulo, Brazil
| | - Luciana M Shaddox
- Division of Periodontology, College of Dentistry, University of Kentucky (UK), Lexington, Kentucky, USA
| | - Renato C V Casarin
- Division of Periodontics, Piracicaba Dental School, University of Campinas (Unicamp), Piracicaba, São Paulo, Brazil
| | - Mauro P Santamaria
- Division of Periodontics, Institute of Science and Technology, São Paulo State University, (Unesp), São José dos Campos, São Paulo, Brazil.,Division of Periodontology, College of Dentistry, University of Kentucky (UK), Lexington, Kentucky, USA
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12
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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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Theodoro LH, Marcantonio RAC, Wainwright M, Garcia VG. LASER in periodontal treatment: is it an effective treatment or science fiction? Braz Oral Res 2021; 35:e099. [PMID: 34586213 DOI: 10.1590/1807-3107bor-2021.vol35.0099] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 12/29/2022] Open
Abstract
There are several studies that evaluate the use of lasers in periodontal treatment in non-surgical or surgical therapy. However, while several studies showed clinically beneficial effects of some lasers in periodontal treatment, there are few clinical reports of additional advantages of lasers as adjunctive treatments in periodontology. The aim of this paper is to demonstrate and critically analyze the level of scientific evidence of effects of low-level lasers and high-power lasers in periodontology. A narrative review of the studies was carried out in each topic and type of laser or periodontal treatment. In nonsurgical periodontal therapy the results showed that there is an additional clinical benefit when using a diode laser (DL) associated with scaling and root planing (SRP) in patients with moderate to severe periodontitis. The Er:YAG laser seems to be the most suitable for nonsurgical periodontal therapy and promotes the same clinical effects as conventional therapy. In periodontal surgery vaporization of the gingival or mucosal tissue can be carried out with DL, CO2, Nd:YAG, Er:YAG and Er,Cr:YSGG lasers. Photobiomodulation (PBM), mediated by low-level lasers associated with non-surgical periodontal therapy, promotes additional benefits in the short term and accelerates the bone and gingival tissue repair process and also reduces postoperative symptoms of periodontal surgery. The effect of antimicrobial Photodynamic Therapy is relevant in the initial reevaluation periods. Studies have shown controversial results of the use of lasers in periodontics, and this fact may be due to the lack of standard parameters of irradiation in each clinical application.
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Affiliation(s)
- Letícia Helena Theodoro
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Diagnostic and Surgery, Araçatuba, SP, Brazil
| | | | - Mark Wainwright
- Liverpool John Moores University, School of Pharmacy & Biomolecular Sciences, Liverpool, UK
| | - Valdir Gouveia Garcia
- Latin American Institute of Dental Research and Education - Ilapeo, Curitiba, PR, Brazil
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14
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Clinical efficacy of single and multiple applications of antimicrobial photodynamic therapy in periodontal maintenance: A systematic review and network meta-analysis. Photodiagnosis Photodyn Ther 2021; 36:102435. [PMID: 34245916 DOI: 10.1016/j.pdpdt.2021.102435] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND At present the clinical efficacy of single (S) versus multiple (M) applications of antimicrobial photodynamic therapy (aPDT) is controversially discussed. AIM To systematically evaluate the clinical efficacy of adjunctive S and M applications of aPDT to subgingival debridement (SD) in the treatment of residual periodontal pockets. METHODS An electronic search was carried out for randomized controlled clinical trials (RCTs) reporting on SD with the adjunctive use of S- or M-aPDT applications. RESULTS Statistically significantly higher improvement in bleeding on probing (BOP) and probing depth (PD) reduction was found for SD + S-aPDT versus SD, with Mean difference (MD) = -16.8 (95% CI: -30.7 to -2.91; p = 0.02) and 0.4, (95% CI: 0.02 to 0.78, p = 0.04), respectively. Regarding BOP, there was also a statistically significant difference when SD + M-aPDT was compared with SD alone, with a MD of -5.13 (95% CI: -7.20 to -3.07; p < 0.00001). For all parameters, SD + S-aPDT demonstrated the best treatment ranking of probability results, followed by SD + M-aPDT and SD alone. CONCLUSIONS Within their limits, the present data indicate that in periodontal patients enrolled in maintenance: a) single and multiple adjunctive applications of aPDT following SD resulted in statistically significant BOP reduction compared to SD alone, and b) repeated applications of aPDT did not seem to result in superior outcomes compared to single applications.
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15
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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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16
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Zhao Y, Pu R, Qian Y, Shi J, Si M. Antimicrobial photodynamic therapy versus antibiotics as an adjunct in the treatment of periodontitis and peri-implantitis: A systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2021; 34:102231. [PMID: 33621702 DOI: 10.1016/j.pdpdt.2021.102231] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/29/2021] [Accepted: 02/16/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Clinical efficacy of antimicrobial photodynamic therapy (aPDT) as compared to antibiotics in periodontitis and peri-implantitis has been tested in several clinical trials. Yet controversial results were reported. The aim of the present study was to answer the question: "Will adjunctive antimicrobial photodynamic therapy be more effective than antibiotics agent in the treatment of periodontitis and peri-implantitis?". METHODS Publications compared outcomes between aPDT and antibiotics in adult patients with periodontitis or peri-implantitis, containing more than 3-month follow-up duration, were involved in the systematic review and meta-analysis. PubMed, EMBASE and Cochrane Central were searched until December of 2020. Clinical parameters including pocket probing depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP) were evaluated. The risk of bias was assessed by Cochrane Collaboration Tool. Weighted mean differences (WMD), 95 % confidence interval(CI) and heterogeneity were estimated by Review Manager software. RESULTS 10 trials in periodontitis and 5 trials in peri-implantitis were included. Meta-analysis outcomes revealed equal clinical evidence for aPDT and antibiotics in periodontitis and peri-implantitis. In addition, aPDT significantly reduced the red complex in both diseases. However, owing to the heterogeneity of protocols in articles and the limited number of studies, the comparative conclusion remained unconfirmed. CONCLUSION aPDT can be considered as an alternative to antibiotics in the treatment of peri-implantitis and periodontitis. Given that high heterogeneity in outcome was found in this review, future long-term clinical trials with standard aPDT and antibiotic treatment should be tested to arrive at a firm conclusion.
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Affiliation(s)
- Yuxin Zhao
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - Rui Pu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - Yinjie Qian
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - Jue Shi
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - Misi Si
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China.
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17
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Soi S, Bains VK, Srivastava R, Madan R. Comparative evaluation of improvement in periodontal and glycemic health status of type 2 diabetes mellitus patients after scaling and root planing with or without adjunctive use of diode laser. Lasers Med Sci 2021; 36:1307-1315. [PMID: 33521870 DOI: 10.1007/s10103-021-03261-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 01/24/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Periodontal treatment in diabetic patients reduces systemic inflammatory burden and hence should be closely coordinated with the patient's overall clinical diabetic management. OBJECTIVE To evaluate the effectiveness of diode laser (DL) (Biolase EpicTM, 940 nm, Irvine, CA, USA) as an adjunct to scaling root and planing (SRP) on periodontal health and glycated hemoglobin (HbA1c) level of type 2 diabetes mellitus (T2DM) patients suffering from generalized chronic periodontitis (CP), currently, stage II or above/grade B or C periodontitis. MATERIALS AND METHODOLOGY After initial screening of 55 T2DM patients, a total of 44 T2DM-CP patients (between the age group of 30 and 65 years) were selected and randomly assigned into two groups. The groups were divided into control group (n=22), treated with scaling and root planing alone (SRP alone), and experimental group (n=22), treated with scaling and root planing along with laser therapy (SRP + DL). Laser irradiation was accomplished at perio pocket setting of 0.8 W (average) in a pulse interval of 1.0 ms and pulse length of 1.0 ms delivering 24 J of energy using a 300-μm fiber optic delivery system. RESULTS Thirty-seven out of 44 enrolled T2DM-CP patients completed the study. Both treatment modalities, i.e., SRP alone and SRP+DL resulted in mean significant (p < 0.001) improvement in periodontal health parameters (plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment loss (CAL)) and glycemic level (RBS, FBS, and HbA1c) in T2DM-CP patients after 6 months, and was higher in SRP+DL group in comparison to SRP alone. Among the periodontal health parameters, the mean PPD reduction and CAL gain were 51.78% and 48.26% in control as compared to 61.56% and 62.54% in experimental group respectively, whereas the mean significant reduction in HbA1c was 13.8% in SRP alone and 22.52% in SRP+DL group after 6 months (p < 0.05). CONCLUSION Periodontal treatment involving SRP+DL contributes to improved periodontal health parameters and HbA1c level in T2DM-CP patients.
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Affiliation(s)
- Sunakshi Soi
- Department of Periodontology, Saraswati Dental College, 233, Tiwari Ganj, Faizabad Road, Chinhat, Lucknow, UP, 226028, India
| | - Vivek Kumar Bains
- Department of Periodontology, Saraswati Dental College, 233, Tiwari Ganj, Faizabad Road, Chinhat, Lucknow, UP, 226028, India.
| | - Ruchi Srivastava
- Department of Periodontology, Saraswati Dental College, 233, Tiwari Ganj, Faizabad Road, Chinhat, Lucknow, UP, 226028, India
| | - Rohit Madan
- Department of Periodontology, Saraswati Dental College, 233, Tiwari Ganj, Faizabad Road, Chinhat, Lucknow, UP, 226028, India
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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.
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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.)
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Li Z, Pan W, Shi E, Bai L, Liu H, Li C, Wang Y, Deng J, Wang Y. A Multifunctional Nanosystem Based on Bacterial Cell-Penetrating Photosensitizer for Fighting Periodontitis Via Combining Photodynamic and Antibiotic Therapies. ACS Biomater Sci Eng 2021; 7:772-786. [PMID: 33411504 DOI: 10.1021/acsbiomaterials.0c01638] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Photodynamic therapy (PDT), an emerging approach that involves photosensitizers, light, and molecular oxygen, has shown promise for fighting periodontitis. However, PDT does not always acquire the desired therapeutic outcomes since some photosensitizers have strong hydrophobic properties and are difficult to absorb efficiently by periodontal pathogenic bacteria. Here, a hydrophobic photosensitizer chlorin e6 (Ce6) was hydrophilically modified via conjugation with TAT peptide, a cationic cell-penetrating peptide, to improve its solubility and enhance its bacterial adsorption by promoting its interaction with the negatively charged cell walls and penetration through the cell membranes. The obtained TAT-Ce6 conjugate (TAT-Ce6) was used to prepare self-assembled nanoparticles (NPs) for loading tinidazole (TDZ), a clinically used antibiotic agent, thus hoping to achieve synergistic antiperiodontitis effects through combining PDT and antibiotic therapy. Compared to free Ce6, TAT-Ce6 nanoparticles (TAT-Ce6 NPs) had greatly enhanced adsorption and penetration abilities for periodontal pathogen bacteria and also exhibited significantly increased PDT efficiencies in both periodontal pathogen bacteria and monocyte macrophages. Upon 635 nm laser irradiation, TDZ-loaded TAT-Ce6 (TAT-Ce6/TDZ) NPs exerted remarkable synergistic antiperiodontitis effects of PDT and antibiotic therapy, reflecting in the effective killing of periodontal pathogenic bacteria in vitro and the reduced adsorption of alveolar bone in the Sprague-Dawley rat model of periodontitis. Altogether, this study develops a novel photosensitizer that can be efficiently absorbed by the periodontal pathogenic bacteria and also provides a potent combination strategy of PDT with antibiotic therapy for clinical periodontitis treatment.
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Affiliation(s)
- Zhiyuan Li
- School of Dentistry & Hospital of Stomatology, Tianjin Medical University, Tianjin 300070, P. R. China
| | - Wei Pan
- School of Dentistry & Hospital of Stomatology, Tianjin Medical University, Tianjin 300070, P. R. China
| | - Enyu Shi
- School of Dentistry & Hospital of Stomatology, Tianjin Medical University, Tianjin 300070, P. R. China
| | - Liya Bai
- The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, Tianjin Key Laboratory on Technologies Enabling Development of Clinical Therapeutics and Diagnostics (Theranostics), School of Pharmacy, Tianjin Medical University, Tianjin 300070, P. R. China
| | - Hui Liu
- The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, Tianjin Key Laboratory on Technologies Enabling Development of Clinical Therapeutics and Diagnostics (Theranostics), School of Pharmacy, Tianjin Medical University, Tianjin 300070, P. R. China
| | - Changyi Li
- School of Dentistry & Hospital of Stomatology, Tianjin Medical University, Tianjin 300070, P. R. China
| | - Yinsong Wang
- The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, Tianjin Key Laboratory on Technologies Enabling Development of Clinical Therapeutics and Diagnostics (Theranostics), School of Pharmacy, Tianjin Medical University, Tianjin 300070, P. R. China
| | - Jiayin Deng
- School of Dentistry & Hospital of Stomatology, Tianjin Medical University, Tianjin 300070, P. R. China
| | - Yue Wang
- School of Dentistry & Hospital of Stomatology, Tianjin Medical University, Tianjin 300070, P. R. China
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The effectiveness of photodynamic and antibiotic gel therapy as an adjunct to mechanical debridement in the treatment of peri-implantitis among diabetic patients. Photodiagnosis Photodyn Ther 2020; 32:102077. [DOI: 10.1016/j.pdpdt.2020.102077] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 10/17/2020] [Accepted: 10/26/2020] [Indexed: 11/19/2022]
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21
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Derikvand N, Ghasemi SS, Safiaghdam H, Piriaei H, Chiniforush N. Antimicrobial Photodynamic Therapy with Diode laser and Methylene blue as an adjunct to scaling and root planning: A clinical trial. Photodiagnosis Photodyn Ther 2020; 31:101818. [DOI: 10.1016/j.pdpdt.2020.101818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/17/2020] [Accepted: 05/04/2020] [Indexed: 10/24/2022]
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Al Deeb M, Alresayes S, A Mokeem S, Alhenaki AM, AlHelal A, Vohra F, Abduljabbar T. Clinical peri-implant health and biological bone marker levels in tobacco users treated with photodynamic therapy. Photodiagnosis Photodyn Ther 2020; 31:101821. [PMID: 32422214 DOI: 10.1016/j.pdpdt.2020.101821] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/02/2020] [Accepted: 05/08/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND What impact does tobacco smoking have on photodynamic therapy (PDT) outcome is still unknown. The aim of the present clinical trial was to evaluate the clinical, radiographic, and biological bone markers after provision of PDT in cigarette, e-cigarette, and never-smokers with peri-implantitis (PI) at 6 months post treatment. MATERIALS AND METHODS Twenty-five healthy patients with PI were divided into three groups: Group I: cigarette smokers; Group II: e-cigarettes users; Group III: never-smokers. Full-mouth mechanical debridement with adjunctive methylene blue-mediated PDT was performed. Clinical recordings included peri-implant plaque index (Pi), bleeding on probing (BOP) and probing depth (PD). Peri-implant sulcular fluid was collected for the assessment of biological bone biomarkers including receptor activator of nuclear factor-ligand (RANK-L) and osteoprotegrin (OPG). All assessments were performed at baseline, 3 months and 6 months. P-value of <0.05 was considered significant. RESULTS BOP in Group II and III significantly reduced at 3 months (p < 0.05). Group I showed significant reduction only at 6 months (p < 0.05). Mean PD showed no statistically significant difference between the groups at any time-point. Inter-group comparison showed Group III demonstrating statistically significantly reduced mean RANK-L levels at both 3 and 6 months (p < 0.05). A slight increase in the OPG levels were observed at 3 months and followed by a slight decrease at 6 months for all the study groups when compared with baseline values, however, these values did not show statistical significance (p > 0.05). CONCLUSION Adjunctive PDT helped in reducing the clinical peri-implant inflammation. However, no significant change was observed for biological bone biomarkers among tobacco smokers.
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Affiliation(s)
- Modhi Al Deeb
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Saad Alresayes
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Sameer A Mokeem
- Department of Periodontics and Community Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Aasem M Alhenaki
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Abdulaziz AlHelal
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; Research Chair for Biological Research in Dental Health, College of Dentistry, Riyadh 11545, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; Research Chair for Biological Research in Dental Health, College of Dentistry, Riyadh 11545, Saudi Arabia
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; Research Chair for Biological Research in Dental Health, College of Dentistry, Riyadh 11545, Saudi Arabia.
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Koidou VP, Cavalli N, Hagi-Pavli E, Nibali L, Donos N. Expression of inflammatory biomarkers and growth factors in gingival crevicular fluid at different healing intervals following non-surgical periodontal treatment: A systematic review. J Periodontal Res 2020; 55:801-809. [PMID: 32840888 DOI: 10.1111/jre.12795] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/01/2020] [Accepted: 07/29/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Non-surgical periodontal treatment (NSPT) is widely employed for the treatment of periodontal disease and yields significant clinical improvements. Gingival crevicular fluid (GCF) can be used to profile health and disease, and recent technological advances, such as multiplex bead immunoassays, are promising in identifying a wider array of GCF factors with the ultimate aim to predict the treatment response. OBJECTIVE The aim of this systematic review was to compare the expression of GCF markers using multiplex bead immunoassays before treatment and during early, average, or late healing period, following non-surgical periodontal treatment (NSPT). METHODS An electronic literature search was conducted by two independent examiners (VK and NC) in MEDLINE, EMBASE, OpenGrey, LILACS, and Cochrane Library up to January 2020. The PICO question formulated was as follows: "In patients with periodontal disease, does the expression of gingival crevicular fluid (GCF) markers detected using multiplex bead immunoassay differ at baseline compared with early (≤30 days), average (6-8 weeks), or late (≥3 months) healing after intervention?" RESULTS A total of 366 publications were obtained and reviewed for eligibility for inclusion. Of these, 12 publications fulfilled the inclusion criteria and were included in the present review. Data for a total of 31 different GCF markers were extracted and summarized for early, average, or late healing after NSPT. Early healing following NSPT (≤ 30 days) indicated an increase in IL-1β, TNFα, and IL-10. At the average healing period (6-8 weeks), IL-1β, IL-1α, IL-6, TNF-α, IFN-γ, GM-CSF, MCP-1, and MIP-1α were all reduced, compared to their respective baseline values. Three months after NSPT, IL-1β, IL-4, IL-6, IL-10, TNF-α, and IFN-γ were detected at reduced levels, compared to pre-treatment levels. Overall, the changes following treatment indicated a reduction of inflammation present at baseline. CONCLUSION Following non-surgical periodontal treatment, an upregulation of inflammation markers is noted early post-operatively and a subsequent reduction of their levels three months following treatment. The investigation of levels of GCF markers associated with inflammation and regeneration, especially using multiplex bead immunoassay technologies, is a valuable tool to better understand the processes associated with healing following periodontal treatment.
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Affiliation(s)
- Vasiliki P Koidou
- Centre for Oral Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, UK
| | - Nicolo Cavalli
- Centre for Oral Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, UK
| | - Eleni Hagi-Pavli
- Centre for Oral Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, UK
| | - Luigi Nibali
- Centre for Oral Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, UK.,Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, Kings College London, London, UK
| | - Nikolaos Donos
- Centre for Oral Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, UK
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Engel Naves Freire A, Macedo Iunes Carrera T, de Oliveira GJPL, Pigossi SC, Vital Ribeiro Júnior N. Comparison between Antimicrobial Photodynamic Therapy and Low-level laser therapy on non-surgical periodontal treatment: A Clinical Study. Photodiagnosis Photodyn Ther 2020; 31:101756. [PMID: 32302705 DOI: 10.1016/j.pdpdt.2020.101756] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/11/2020] [Accepted: 03/20/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Alternative antibacterial therapeutic modalities, such as antimicrobial photodynamic therapy (aPDT) and low-level laser therapy (LLLT), have been proposed to improve the effectiveness of periodontal treatment. However, clinical studies evaluating the efficiency of these treatments have been inconclusive, partly due to contradictory results regarding their clinical and microbiological effects. The aim of this study was to evaluate the clinical effects of aPDT and LLLT after a one-stage full-mouth disinfection (OSFMD) protocol during periodontitis treatment. METHODS A split-mouth clinical trial was conducted in 20 patients presenting at least two contralateral teeth with a probing pocket depth (PD) ≥ 5 mm and bleeding on probing (BOP) on both sides of the mouth. All patients were submitted to an OSFMD protocol. The selected sites randomly received either (1) aPDT (methylene blue as a photosensitizer activated by red and infrared diode laser) or (2) LLLT (red and infrared diode laser). Clinical parameters were assessed at baseline and at 4 and 12 weeks post-treatment. RESULTS Both treatment protocols promoted significant reductions in PD, number of deep pockets and BOP and an increase in clinical attachment level (CAL) after 4 and 12 weeks, but there were no differences between the two groups. There was no change in the gingival level (GL) of either group for all periods of analysis. A decrease in the number of moderate pockets (4-5 mm) was found in the LLLT group (5.15 ± 4.20) when compared to the aPDT group (7.10 ± 5.24), but only after 4 weeks. CONCLUSIONS In conclusion, both the aPDT and LLLT therapies promoted improvements in periodontal clinical parameters after the OSFMD protocol; however, in general, there were no distinct differences between the two treatment modalities evaluated in this study.
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Affiliation(s)
- Alice Engel Naves Freire
- Department of Clinics and Surgery, School of Dentistry, Alfenas Federal University, Gabriel Monteiro St, 700, Center, 37130-001, Alfenas, MG, Brazil
| | - Thaisa Macedo Iunes Carrera
- Department of Clinics and Surgery, School of Dentistry, Alfenas Federal University, Gabriel Monteiro St, 700, Center, 37130-001, Alfenas, MG, Brazil
| | | | - Suzane Cristina Pigossi
- Department of Clinics and Surgery, School of Dentistry, Alfenas Federal University, Gabriel Monteiro St, 700, Center, 37130-001, Alfenas, MG, Brazil.
| | - Noé Vital Ribeiro Júnior
- Department of Clinics and Surgery, School of Dentistry, Alfenas Federal University, Gabriel Monteiro St, 700, Center, 37130-001, Alfenas, MG, Brazil
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Siva NTD, Silva DNDA, Azevedo MLDS, Silva Júnior FLD, Almeida ML, Longo JPF, Moraes MD, Gurgel BCDV, de Aquino Martins ARL. The effectiveness of photodynamic therapy as a complementary therapy to mechanical instrumentation on residual periodontal pocket clinical parameters: A clinical split-mouth test. Photodiagnosis Photodyn Ther 2019; 29:101565. [PMID: 31586644 DOI: 10.1016/j.pdpdt.2019.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/25/2019] [Accepted: 09/30/2019] [Indexed: 12/27/2022]
Abstract
The purpose of this study was to evaluate the effectiveness of photodynamic therapy as complementary therapy to mechanical instrumentation on periodontal residual pockets. This longitudinal, prospective, double-blind and controlled split-mouth clinical trial included one hundred and fourteen residual periodontal sites with probing depth ≥ 4 mm and bleeding on probing, which were distributed into two groups: 57 in the test group (SRP + aPDT) - using a low power laser application Therapy XT (DMC Equipamentos Ltda, São Carlos, São Paulo, Brazil) with operational parameters of 660 nm and 110 mW for 15s, and 57 in the control group (SRP). Oral hygiene conditions were evaluated, through the Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI), as well as periodontal clinical outcomes, comprising the Bleeding on Probing (BOP), Probing Depth (PD) and Clinical Attachment Level (CAL) at baseline and after 3 months. Decrease of 17.74% was observed for the VPI after 3 months of follow-up, while the GBI was reduced by 19.91%, thus indicating statistically significant decreases for both parameters (p < 0.001). Decreases in VPI per site, BOP and PD and CAL gain between T0 and T3 in both treatment groups (p < 0.001) were observed, but no statistically significant intergroup differences were found (p > 0.05). Within the parameters used in this study, adjuvant aPDT to SRP did not lead additional benefits regarding the assessed clinical parameters after three months.
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Affiliation(s)
| | | | | | | | | | - João Paulo Figueiró Longo
- Department of Genetics and Morphology, Institute of Biological Sciences, University of Brasília, Brasília, DF, Brazil.
| | - Maiara de Moraes
- Department of Health Sciences, Center for Biological and Health Sciences, Medicine, Rural Federal University of Semi-Árido (UFERSA), Mossoró, Rio Grande do Norte, RN, Brazil.
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Photonic Therapy in Periodontal Diseases an Overview with Appraisal of the Literature and Reasoned Treatment Recommendations. Int J Mol Sci 2019; 20:ijms20194741. [PMID: 31554277 PMCID: PMC6801906 DOI: 10.3390/ijms20194741] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/13/2019] [Accepted: 09/21/2019] [Indexed: 12/26/2022] Open
Abstract
Recent reviews and meta-analyses of the literature over the past quarter-century have failed to provide enough evidence to prove or disprove the actual utility of photonic therapy in periodontitis, alone or adjunctive to conventional approaches. This apparent paradox has been explained by the many physical, molecular, biological, anatomical, and technical variables of photonic treatments, which can differ in light-emitting devices (laser or LED), wavelengths, irradiation power and modes, clinical objectives, follow-up times, disease grading, and assessment methods. This multi-faceted, controversial scenario has led practitioners to underestimate the actual potential of photonic therapy in periodontal diseases. In this critical appraisal of the literature, we have briefly summarized the main photonic therapies and instruments used in Periodontology, highlighting their main characteristics and limitations. Then, we have tried to identify and discuss the key methodological issues which can have an impact on the outcome of photonic therapies. Our main goal was to identify the best parameters, settings, and methodologies to perform effective periodontal photonic treatments and to extrapolate some recommendations for clinical use. Should these recommendations find a consensus among periodontologists and be adopted in future clinical studies, they will hopefully contribute to dissipate the present confusion and uncertainty on this complex matter.
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Methylene Blue-Mediated Photodynamic Therapy Induces Macrophage Apoptosis via ROS and Reduces Bone Resorption in Periodontitis. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:1529520. [PMID: 31485288 PMCID: PMC6710739 DOI: 10.1155/2019/1529520] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/01/2019] [Accepted: 05/06/2019] [Indexed: 12/13/2022]
Abstract
Aim To investigate whether methylene blue-mediated photodynamic therapy (MB-PDT) can affect the "fate" of macrophages in vitro or in periodontitis tissues and to explore the potential mechanism. Methods For in vitro treatments, THP-1 macrophages were divided into three experimental groups: C/control, no treatment; MB, methylene blue treatment; and MB-PDT, MB and laser irradiation treatment. Then, apoptosis and apoptosis-related proteins were detected in each group. For in vivo treatments, periodontitis was ligature-induced in the first molars of the bilateral maxilla in 12 Sprague Dawley (SD) rats. After six weeks, the ligatures were removed and all the induced molars underwent scaling and root planning (SRP). Then, the rats were divided into three groups according to the following treatments: SRP, saline solution; MB, phenothiazinium dye; and MB-PDT, MB and laser irradiation. Apoptotic macrophages, inflammation levels, and alveolar bone resorption in the periodontal tissues of rats were analyzed in each group. Results In vitro, flow cytometry analysis demonstrated that 10 μM MB and 40 J/cm2 laser irradiation maximized the apoptosis rate (34.74%) in macrophages. Fluorescence probe and Western blot analyses showed that MB-PDT induced macrophage apoptosis via reactive oxygen species (ROS) and the mitochondrial-dependent apoptotic pathway. Conversely, the addition of exogenous antioxidant glutathione (GSH) and the pan-caspase inhibitor Z-VAD-FMK markedly reduced the apoptotic response in macrophages. In vivo, immunohistochemistry, histology, radiographic, and molecular biology experiments revealed fewer infiltrated macrophages, less bone loss, and lower IL-1β and TNF-α levels in the MB-PDT group than in the SRP and MB groups (P < 0.05). Immunohistochemistry analysis also detected apoptotic macrophages in the MB-PDT group. Conclusion MB-PDT could induce macrophage apoptosis in vitro and in rats with periodontitis. This may be another way for MB-PDT to relieve periodontitis in addition to its antimicrobial effect. Meanwhile, MB-PDT induced apoptosis in THP-1 macrophages via the mitochondrial caspase pathway.
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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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Multiple aPDT sessions on periodontitis in rats treated with chemotherapy: histomorphometrical, immunohistochemical, immunological and microbiological analyses. Photodiagnosis Photodyn Ther 2019; 25:92-102. [DOI: 10.1016/j.pdpdt.2018.11.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 10/11/2018] [Accepted: 11/19/2018] [Indexed: 12/12/2022]
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Habashneh RA, Mashal MA, Khader Y, Qudah R. Clinical and Biological Effects of Adjunctive Photodynamic Therapy in Refractory Periodontitis. J Lasers Med Sci 2019; 10:139-145. [PMID: 31360383 PMCID: PMC6499576 DOI: 10.15171/jlms.2019.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: To date, no novel treatment approach is available for optimum outcomes regarding refractory periodontitis. The aim of the present study was to assess the efficiency of photodynamic therapy (PDT) in treating patients diagnosed with refractory periodontitis and compare the clinical and biological outcomes of conventional periodontal treatment with or without adjunctive PDT in these patients, by assessing clinical parameters (plaque index [PI], gingival recession [GR], bleeding on probing [BOP], periodontal probing depth [PPD] and clinical attachment level [CAL]) as well as biological parameters (IL-1β) in the gingival crevicular fluid (GCF). Methods: Sixteen patients within the age of 30 to 60 years, with a mean age of 40 years old, diagnosed with refractory periodontitis were included. In this split mouth design study, 2 quads (1 upper + 1 lower) from the same patient were randomly treated with (scaling and root planing [SRP]+PDT) together. The other 2 quadrants (1 upper + 1 lower) were treated by SRP only and selected to serve as controls. Clinical parameters including PI, GR, BOP, PPD and CAL and biological parameters (IL-1β) in the GCF were measured at baseline, then at, 2 and 6 months after therapy. Results: A statistically significant reduction in several clinical parameters as, BOP (P < 0.001), PI (P < 0.001), PPD (P < 0.001) and CAL (P < 0.001) in quadrant treated with SRP and adjunctive PDT when compared to control group treated with SRP alone was observed and both therapies showed non-statistically significant differences in the reduction of IL-1β level. Conclusion: The inclusion of PDT as an adjunctive measure to nonsurgical conventional periodontal treatment seems to be a useful therapeutic measure in refractory periodontitis treatment.
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Affiliation(s)
- Rola Al Habashneh
- Department of Preventive Dentistry, Jordan University of Science and Technology, Ramtha, Jordan
| | - Mohammad A Mashal
- Department of Preventive Dentistry, Jordan University of Science and Technology, Ramtha, Jordan
| | - Yousef Khader
- Medical Education and Biostatistics, Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science & Technology, Ramtha, Jordan
| | - Rana Qudah
- Department of Preventive Dentistry, Jordan University of Science and Technology, Ramtha, Jordan
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The effects of repeated applications of antimicrobial photodynamic therapy in the treatment of residual periodontal pockets: a systematic review. Lasers Med Sci 2018; 34:855-863. [DOI: 10.1007/s10103-018-02703-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/03/2018] [Indexed: 01/12/2023]
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Gómez C, Abellán R, Palma JC. Efficacy of photodynamic therapy vs ultrasonic scaler for preventing gingival inflammation and white spot lesions during orthodontic treatment. Photodiagnosis Photodyn Ther 2018; 24:377-383. [PMID: 30399455 DOI: 10.1016/j.pdpdt.2018.11.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/21/2018] [Accepted: 11/02/2018] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The complex designs of fixed orthodontic appliances hinder proper access for cleaning, favouring the development of gingival inflammation and white spot lesions around brackets. The aim of this study was to evaluate the effectiveness to avoid these undesirable effects by using two prophylactic methods: Photodynamic Therapy (PDT) and conventional ultrasonic scaler (US), in patients during fixed orthodontic treatment. MATERIALS AND METHODS Twenty patients under orthodontic treatment for at least 15 months were randomly divided into two groups: PDT mediated by methylene blue (MB) and US. Both treatments were applied in repeated doses (four times in intervals of 2 weeks in the beginning of the study (T0), with booster doses at 3, 6 and 9 months, T1, T2 and T3, respectively). Periodontal clinical parameters (full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS) and probing depth (PD)) were recorded as well as the International Caries Detection and Assessment System (ICDAS) index. Samples of subgingival plaque and saliva (for determination of 4 periodontopathogens and mutans streptococci, respectively), were collected at T0 and at the follow-ups of T1, T2 and T3. RESULTS The evolution of FMPS, FMBS, PD, ICDAS scores as well as the counts of periodontopathogens and salivary mutans streptococci was similar after US or PDT implementation. Greatest periodontal scores reduction took place at T1 for FMBS and PD and at T2 for FMPS. Main microbial reduction took place at T1. ICDAS index began to increase from T2. No statistically significant intergroup differences were observed. CONCLUSIONS Additional treatment of PDT or US in repeated doses delayed undesired side effects during fixed orthodontic treatment in young patients with low caries risk and signs of gingival inflammation.
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Affiliation(s)
- Clara Gómez
- Institute of Physical Chemistry Rocasolano, CSIC, Serrano 119, 28006 Madrid, Spain.
| | - Rosa Abellán
- Department of Dental Clinical Specialities, School of Dentistry, Complutense University of Madrid, Plaza Ramón y Cajal sn, 28040 Madrid, Spain
| | - Juan Carlos Palma
- Department of Dental Clinical Specialities, School of Dentistry, Complutense University of Madrid, Plaza Ramón y Cajal sn, 28040 Madrid, Spain
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Meza-Mauricio J, Soto-Peñaloza D, Peñarrocha-Oltra D, Montiel-Company JM, Peruzzo DC. Locally applied statins as adjuvants to non-surgical periodontal treatment for chronic periodontitis: a systematic review and meta-analysis. Clin Oral Investig 2018; 22:2413-2430. [DOI: 10.1007/s00784-018-2507-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 05/30/2018] [Indexed: 12/22/2022]
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Effects of Antimicrobial Photodynamic Therapy and Local Administration of Minocycline on Clinical, Microbiological, and Inflammatory Markers of Periodontal Pockets: A Pilot Study. Int J Dent 2018; 2018:1748584. [PMID: 29849634 PMCID: PMC5907519 DOI: 10.1155/2018/1748584] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 01/15/2018] [Accepted: 02/27/2018] [Indexed: 01/04/2023] Open
Abstract
Objective We evaluated the efficacies of antimicrobial photodynamic therapy (aPDT) and minocycline ointment (MO) on clinical and bacteriological markers and the local host inflammatory response. Materials and Methods A total of 30 patients with chronic periodontitis were randomly assigned to two groups. Selected periodontal pockets (probing depth 5-7 mm with bleeding on probing) were treated with aPDT or MO. Measurements of clinical parameters and the collection of gingival crevicular fluid (GCF) and subgingival plaque were performed at baseline, and at 1 and 4 weeks after treatment. Quantification of periodontopathic bacteria in the sulcus and a multiplex bead immunoassay of ten inflammatory cytokines in the GCF were performed. Results Local MO administration exhibited a significant decrease in scores for clinical parameters (P < 0.01) and a significant reduction in bacterial counts (P < 0.01) and interleukin-1β and interferon-γ levels at 1 and 4 weeks after treatment (P < 0.01). No significant changes were observed in the aPDT group, except in clinical parameters. Conclusions Although our study had some limitations, we found that while local administration of MO may slightly help to improve clinical, microbiological, and crevicular cytokine levels in periodontal pockets, aPDT did not show any effects. This trial is registered with the UMIN Clinical Trials Registry UMIN000013376.
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Rahman SU, Mosca RC, Govindool Reddy S, Nunez SC, Andreana S, Mang TS, Arany PR. Learning from clinical phenotypes: Low-dose biophotonics therapies in oral diseases. Oral Dis 2018; 24:261-276. [DOI: 10.1111/odi.12796] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 10/06/2017] [Accepted: 10/09/2017] [Indexed: 01/03/2023]
Affiliation(s)
- SU Rahman
- Oral Biology; School of Dental Medicine; University at Buffalo; Buffalo NY USA
| | - RC Mosca
- Oral Biology; School of Dental Medicine; University at Buffalo; Buffalo NY USA
- Energetic and Nuclear Research Institute; Radiation Technology Center; São Paulo Brazil
| | - S Govindool Reddy
- Oral Biology; School of Dental Medicine; University at Buffalo; Buffalo NY USA
| | - SC Nunez
- Biomedical Engineering and Bioengineering; Universidade Brasil; São Paulo Brazil
| | - S Andreana
- Restorative and Implant Dentistry; School of Dental Medicine; University at Buffalo; Buffalo NY USA
| | - TS Mang
- Oral and Maxillofacial Surgery; School of Dental Medicine; University at Buffalo; Buffalo NY USA
| | - PR Arany
- Oral Biology; School of Dental Medicine; University at Buffalo; Buffalo NY USA
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Giorgetti APO, Matos RD, Casarin RCV, Pimentel SP, Cirano FR, Ribeiro FV. Preemptive and Postoperative Medication Protocols for Root Coverage Combined with Connective Tissue Graft. Braz Dent J 2018; 29:23-29. [DOI: 10.1590/0103-6440201801452] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 11/06/2017] [Indexed: 11/22/2022] Open
Abstract
Abstract This trial evaluated the preemptive and postoperative effect of dexamethasone and ibuprofen on prevention of pain/discomfort, edema and interference in daily life in patients undergoing root coverage combined with subepithelial connective tissue graft (CAF + CTG). Twenty patients were randomly assigned as follows: NSAID Group: 400mg Ibuprofen 60 min preemptive + 400mg Ibuprofen postoperative; or SAID Group: 4mg Dexamethasone 60 min preemptive + 4mg Dexamethasone postoperative. The postoperative medication was administered 8 and 16 h post-surgery. Each patient received questionnaires based on a numeric scale (101-point numeric scale rate [NRS-101]) and multiple choice questions (four-point verbal rating scale [VRS-4]) about trans-operative pain/discomfort, hourly for 8 h after surgery and once a day for three days. A Visual Analogue Scale (VAS) for edema and interference in daily life during the 1st, 2nd, 3rd and 7th day was also answered. The degree of anxiety was rated statistically by the Chi-square test. The Mann-Whitney and Friedman tests were used for the other questionnaires. The surgery time and number of analgesic pills consumed were compared using Student’s t-test. Patients who used dexamethasone presented a trend toward less pain when compared to individuals who ingested ibuprofen, with a significant difference observed 3 h after the procedure (p<0.05). The use of dexamethasone also promoted less edema until the 2nd day and lower interference in daily life on the third day when compared with ibuprofen (p<0.05). We concluded that the use of dexamethasone as a preemptive and postoperative medication was more suitable as a drug therapeutic protocol for CAF + CTG.
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de Oliveira GJPL, Aroni MAT, Medeiros MC, Marcantonio E, Marcantonio RAC. Effect of low-level laser therapy on the healing of sites grafted with coagulum, deproteinized bovine bone, and biphasic ceramic made of hydroxyapatite and β-tricalcium phosphate. In vivo study in rats. Lasers Surg Med 2018; 50:651-660. [PMID: 29331041 DOI: 10.1002/lsm.22787] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of low-level laser therapy (LLLT) on the healing of biomaterial graft areas (i.e., coagulum, deproteinized bovine bone, and biphasic ceramics comprising hydroxyapatite and β-tricalcium phosphate). MATERIAL AND METHODS Ninety rats were divided into two groups according to laser irradiation use (λ 808 nm, 100 mW, φ ∼600 μm, seven sessions with 28 J of irradiation dose in total): a laser group and a control group. Each of these groups was divided into three subgroups of 15 animals each according to the type of biomaterial used: Coagulum (COA), deproteinized bovine bone (DBB), and hydroxyapatite/β-tricalcium phosphate (HA/βTCP). Biomaterials were inserted into Teflon domes, and these domes were grafted to the lateral aspect of the mandibular branch of the rats. The animals were sacrificed after 30, 60, and 90 days. Scarring patterns were evaluated by microtomography and histometry. The expression levels of BMP2, osteocalcin (OCN), and alkaline phosphatase (ALP) were evaluated by immunohistochemistry. The mRNA expression levels of ALP, BMP2, Jagged1, Osterix, Runx2, and TGFβ1 were determined by RT-qPCR. RESULTS The animals treated with LLLT exhibited increased mineralized tissues and bone, particularly after 90 days. These increases were associated with increased BMP2, OCN, and ALP protein expression and ALP, BMP2, and Jagged1 mRNA expression. CONCLUSION LLLT improved the osteoconductive potential of DBB and HA/βTCP grafts and bone formation in ungrafted areas. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Guilherme J P L de Oliveira
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of Sao Paulo (Universidade Estadual Paulista-UNESP), Humaitá st.1680, Araraquara, São Paulo, 14801-930, Brazil
| | - Maurício A T Aroni
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of Sao Paulo (Universidade Estadual Paulista-UNESP), Humaitá st.1680, Araraquara, São Paulo, 14801-930, Brazil
| | - Marcell C Medeiros
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of Sao Paulo (Universidade Estadual Paulista-UNESP), Humaitá st.1680, Araraquara, São Paulo, 14801-930, Brazil
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of Sao Paulo (Universidade Estadual Paulista-UNESP), Humaitá st.1680, Araraquara, São Paulo, 14801-930, Brazil
| | - Rosemary A C Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of Sao Paulo (Universidade Estadual Paulista-UNESP), Humaitá st.1680, Araraquara, São Paulo, 14801-930, Brazil
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Bundidpun P, Srisuwantha R, Laosrisin N. Clinical effects of photodynamic therapy as an adjunct to full-mouth ultrasonic scaling and root planing in treatment of chronic periodontitis. Laser Ther 2018; 27:33-39. [PMID: 29795969 DOI: 10.5978/islsm.18-or-03] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 09/27/2017] [Indexed: 01/14/2023]
Abstract
Background and aims Photodynamic therapy (PDT) is a potential strategy to eliminate infection in the specific tissue. It uses lower-power laser to activate a photosensitizing agent. Studies have shown the benefit of PDT in the periodontal treatment. The aim of this study was to evaluate the periodontal changes after applying PDT as an adjunct to one visit full-mouth SRP (scaling and root planing) with subgingival piezoelectric ultrasonic scaler compared with full-mouth SRP alone. Methods A split-mouth randomized clinical trial was designed. Twenty patients with moderate to severe chronic periodontitis were treated with subgingival piezoelectric ultrasonic device alone in control group and adjunct treated with PDT in the test group. Probing pocket depth (PD), clinical attachment level (CAL), plaque index (PI), gingival bleeding index (GBI) and gingival inflammation index (GI) were evaluated at baseline, 1 month, 3 and 6 months after treatment. Only sites with PD ≥ 4 mm at baseline were calculated. Results All periodontal parameters were significantly improved in both groups at 1 month, 3 and 6 months after treatment. All parameters in test group were better than that control group, with statistically significant differences of GBI and GI (P < 0.05) at 3 and 6 months after treatment but no statistically significant differences of PD, CAL and PI. Conclusions One visit full-mouth ultrasonic SRP seems to have good enough effort for the periodontal status till 6 months. The adjunct treatment of PDT provided positive effect in term of GBI and GI.
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Affiliation(s)
| | - Rungtiwa Srisuwantha
- Department of Conservative Dentistry and Prosthodontics, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - Narongsak Laosrisin
- Department of Conservative Dentistry and Prosthodontics, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
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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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Rineh A, Dolla NK, Ball AR, Magana M, Bremner JB, Hamblin MR, Tegos GP, Kelso MJ. Attaching the NorA Efflux Pump Inhibitor INF55 to Methylene Blue Enhances Antimicrobial Photodynamic Inactivation of Methicillin-Resistant Staphylococcus aureus in Vitro and in Vivo. ACS Infect Dis 2017; 3:756-766. [PMID: 28799332 PMCID: PMC6225778 DOI: 10.1021/acsinfecdis.7b00095] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Antimicrobial photodynamic inactivation (aPDI) uses photosensitizers (PSs) and harmless visible light to generate reactive oxygen species (ROS) and kill microbes. Multidrug efflux systems can moderate the phototoxic effects of PSs by expelling the compounds from cells. We hypothesized that increasing intracellular concentrations of PSs by inhibiting efflux with a covalently attached efflux pump inhibitor (EPI) would enhance bacterial cell phototoxicity and reduce exposure of neighboring host cells to damaging ROS. In this study, we tested the hypothesis by linking NorA EPIs to methylene blue (MB) and examining the photoantimicrobial activity of the EPI-MB hybrids against the human pathogen methicillin-resistant Staphylococcus aureus (MRSA). Photochemical/photophysical and in vitro microbiological evaluation of 16 hybrids carrying four different NorA EPIs attached to MB via four linker types identified INF55-(Ac)en-MB 12 as a lead. Compound 12 showed increased uptake into S. aureus cells and enhanced aPDI activity and wound healing effects (relative to MB) in a murine model of an abrasion wound infected by MRSA. The study supports a new approach for treating localized multidrug-resistant MRSA infections and paves the way for wider exploration of the EPI-PS hybrid strategy in aPDI.
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Affiliation(s)
- Ardeshir Rineh
- Illawarra Health and Medical Research Institute and School of Chemistry, University of Wollongong, Northfields Ave., Wollongong, New South Wales 2522, Australia
| | - Naveen K. Dolla
- Illawarra Health and Medical Research Institute and School of Chemistry, University of Wollongong, Northfields Ave., Wollongong, New South Wales 2522, Australia
| | | | - Maria Magana
- Department of Biopathology and Clinical Microbiology, Athens Medical School, Aeginition Hospital, Athens 115 28, Greece
| | - John B. Bremner
- Illawarra Health and Medical Research Institute and School of Chemistry, University of Wollongong, Northfields Ave., Wollongong, New South Wales 2522, Australia
| | - Michael R. Hamblin
- The Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts 02114, United States
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts 02114, United States
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts 02114, United States
| | | | - Michael J. Kelso
- Illawarra Health and Medical Research Institute and School of Chemistry, University of Wollongong, Northfields Ave., Wollongong, New South Wales 2522, Australia
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Pulikkotil SJ, Toh CG, Mohandas K, Leong K. Effect of photodynamic therapy adjunct to scaling and root planing in periodontitis patients: A randomized clinical trial. Aust Dent J 2017; 61:440-445. [PMID: 26780271 DOI: 10.1111/adj.12409] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND A randomized split-mouth controlled clinical trial was conducted to evaluate the efficacy of photodynamic therapy (PDT) in reducing Aggregatibacter actinomycetemcomitans (Aa) in periodontitis patients. METHODS Twenty patients with periodontitis were recruited for the trial. Following random allocation of either quadrants of the selected jaw to test or control treatment, conventional non-surgical periodontal therapy (NSPT) was performed. In addition, the test side received adjunct photodynamic therapy. Probing depth (PD), clinical attachment level, bleeding on probing (BoP) and plaque scores (PS%) were recorded at phase 0 (baseline), phase 1 (immediately after NSPT), phase 2 (7 days following NSPT), phase 3 (1 month following NSPT) and phase 4 (3 months following NSPT). Subgingival plaque samples for quantification of Aa by real-time polymerase chain reaction was performed at phases 0, 1, 2 and 4. RESULTS There was a significant clinical improvement at phases 3 and 4 compared with baseline while BoP reduced significantly only in the test group at phase 4. However, no difference in the quantification of Aa was detected between the groups. CONCLUSIONS Within the limits of the study, PDT adjunct to scaling and root planing does not lead to quantitative reduction of Aa in periodontitis patients.
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Affiliation(s)
- S J Pulikkotil
- School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - C G Toh
- School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - K Mohandas
- Department of Microbiology, Faculty of Medicine, Malaysian Allied Health Science University (MAHSA), Kuala Lumpur, Malaysia
| | - Kvg Leong
- International Medical University, Kuala Lumpur, Malaysia
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Comparison of repeated applications of aPDT with amoxicillin and metronidazole in the treatment of chronic periodontitis: A short-term study. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2017; 174:364-369. [DOI: 10.1016/j.jphotobiol.2017.08.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 07/24/2017] [Accepted: 08/07/2017] [Indexed: 01/11/2023]
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Meimandi M, Talebi Ardakani MR, Esmaeil Nejad A, Yousefnejad P, Saebi K, Tayeed MH. The Effect of Photodynamic Therapy in the Treatment of Chronic Periodontitis: A Review of Literature. J Lasers Med Sci 2017; 8:S7-S11. [PMID: 29263777 DOI: 10.15171/jlms.2017.s2] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Introduction: Chronic periodontitis is the most common periodontal disease which is related to the chronic accumulation of bacterial plaque. Since mechanical methods are not sufficient in the treatment of this disease, administration of local/systemic antibiotic is recommended following mechanical debridement. However, side effects of antibiotics such as microbial resistance and patient allergy led to development of alternative methods. One of these suggested methods is the antimicrobial photodynamic therapy (aPDT). PDT is a local noninvasive treatment modality without the side effects caused by antibiotics. The aim of this study was to review the articles related to the application of PDT with laser in the treatment of chronic periodontitis. Review of literature: In the present review of literature, the authors used key words such as chronic periodontitis, laser and photodynamic therapy, and conducted a literature search via Google Scholar and PubMed for the period of 1990 to 2015. A total of 47 articles in English were found. The articles that were not associated with the topic of research and review articles were deleted and only clinical trials were evaluated. After reviewing 23 articles' abstracts, the full texts of 16 articles were analyzed. Conclusion: Considering the safety, the lack of side effects and general advantages like more patient compliance, the PDT treatment with scaling and root planing (SRP) is recommended as an efficient adjunctive modality for the treatment of localized chronic periodontitis especially during the maintenance phase in non-surgical treatment.
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Affiliation(s)
- Mansour Meimandi
- Periodontics Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Azadeh Esmaeil Nejad
- Periodontics Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Mohammad Hossein Tayeed
- Dental Student, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Laleman I, Cortellini S, De Winter S, Rodriguez Herrero E, Dekeyser C, Quirynen M, Teughels W. Subgingival debridement: end point, methods and how often? Periodontol 2000 2017; 75:189-204. [DOI: 10.1111/prd.12204] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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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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Antimicrobial photodynamic therapy combined to periodontal treatment: Experimental model. Photodiagnosis Photodyn Ther 2017; 18:275-278. [DOI: 10.1016/j.pdpdt.2017.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/03/2017] [Accepted: 03/13/2017] [Indexed: 12/14/2022]
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Angst PDM, Stadler AF, Oppermann RV, Gomes SC. Microbiological outcomes from different periodontal maintenance interventions: a systematic review. Braz Oral Res 2017; 31:e33. [PMID: 28513785 DOI: 10.1590/1807-3107bor-2017vol310033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 03/27/2017] [Indexed: 11/21/2022] Open
Abstract
This study aimed to investigate the differences in the subgingival microbiological outcomes between periodontal patients submitted to a supragingival control (SPG) regimen as compared to subgingival scaling and root planing performed combined with supragingival debridement (SPG + SBG) intervention during the periodontal maintenance period (PMP). A systematic literature search using electronic databases (MEDLINE and EMBASE) was conducted looking for articles published up to August 2016 and independent of language. Two independent reviewers performed the study selection, quality assessment and data collection. Only human randomized or non-randomized clinical trials with at least 6-months-follow-up after periodontal treatment and presenting subgingival microbiological outcomes related to SPG and/or SPG+SBG therapies were included. Search strategy found 2,250 titles. Among these, 148 (after title analysis) and 39 (after abstract analysis) papers were considered to be relevant. Finally, 19 studies were selected after full-text analysis. No article had a direct comparison between the therapies. Five SPG and 14 SPG+SBG studies presented experimental groups with these respective regimens and were descriptively analyzed while most of the results were only presented graphically. The results showed that both SPG and SPG+SBG protocols of PMP determined stability in the microbiological results along time. Nevertheless, new studies comparing these interventions in PMP are needed, especially if the limitations herein discussed could be better controlled.
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Affiliation(s)
| | - Amanda Finger Stadler
- Augusta University, The Dental College of Georgia, Department of Periodontics, Augusta, GA, United States of America
| | - Rui Vicente Oppermann
- Universidade Federal do Rio Grande do Sul - UFRGS, Dental School, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
| | - Sabrina Carvalho Gomes
- Universidade Federal do Rio Grande do Sul - UFRGS, Dental School, Department of Conservative Dentistry, Porto Alegre, RS, Brazil
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Xue D, Zhao Y. Clinical effectiveness of adjunctive antimicrobial photodynamic therapy for residual pockets during supportive periodontal therapy: A systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2017; 17:127-133. [DOI: 10.1016/j.pdpdt.2016.11.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 10/21/2016] [Accepted: 11/19/2016] [Indexed: 11/27/2022]
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Costa da Mota AC, França CM, Prates R, Deana AM, Costa Santos L, Lopes Garcia R, Leal Gonçalves ML, Mesquita Ferrari RA, Porta Santos Fernandes K, Kalil Bussadori S. Effect of photodynamic therapy for the treatment of halitosis in adolescents - a controlled, microbiological, clinical trial. JOURNAL OF BIOPHOTONICS 2016; 9:1337-1343. [PMID: 27248838 DOI: 10.1002/jbio.201600067] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/05/2016] [Accepted: 05/06/2016] [Indexed: 06/05/2023]
Abstract
Halitosis can exert a negative influence on the social relations of adolescents and affect one's self-image. The aim of this study was to evaluate the clinical and microbiological effect of antimicrobial photodynamic therapy (aPDT) on halitosis in adolescents. Forty-six individuals aged 12 to 19 years were randomly allocated: Group 1 - treatment with photodynamic therapy; Group 2 - treatment with a tongue scraper and Group 3 - treatment with a tongue scraper and photodynamic therapy. The count of bacterial colony-forming units per milliliter was used for the microbiological analysis. Statistical analysis involved the Kruskal-Wallis test followed by the Student-Newman-Keuls test. ANOVA was used for the determination of colony-forming units after treatment. The level of significance for all statistical tests was 5% (p < 0.05). After treatment, a statistically significant reduction in total volatile sulfur compounds was found in all groups (p < 0.001), with the largest reduction (median: 0) found in Group 3 (tongue scraper and photodynamic therapy). Moreover, a statistically significant difference was found between treatment with aPDT and a tongue scraper alone (p < 0.001). The present findings demonstrate an option for the treatment of halitosis in adolescents, with an immediate effect and without the mechanical aggression to the toungue. Clinical Trials: NCT02007993.
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Affiliation(s)
| | - Cristiane Miranda França
- Biophotonics Applied to Science Health, Nove de Julho Universit, R. Vergueiro 235, São Paulo, Brasil
| | - Renato Prates
- Biophotonics Applied to Science Health, Nove de Julho Universit, R. Vergueiro 235, São Paulo, Brasil
| | - Alessandro Melo Deana
- Biophotonics Applied to Science Health, Nove de Julho Universit, R. Vergueiro 235, São Paulo, Brasil
| | - Larissa Costa Santos
- Biophotonics Applied to Science Health, Nove de Julho Universit, R. Vergueiro 235, São Paulo, Brasil
| | - Rubia Lopes Garcia
- Biophotonics Applied to Science Health, Nove de Julho Universit, R. Vergueiro 235, São Paulo, Brasil
| | | | | | | | - Sandra Kalil Bussadori
- Biophotonics Applied to Science Health, Nove de Julho Universit, R. Vergueiro 235, São Paulo, Brasil
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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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