Photodynamic therapy treatment as additional non-surgical treatment of chronic periodontitis in smokers and evaluation of microbiological parameters: a clinical randomized controlled trial

• Grant number: 13/00731-5
• Support Opportunities: Regular Research Grants
• Start date: November 01, 2013
• End date: October 31, 2015
• Field of knowledge: Health Sciences - Dentistry - Periodontology
• Principal Investigator: Giorgio de Micheli
• Grantee: Giorgio de Micheli
• Host Institution: Faculdade de Odontologia (FO). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated researchers: Marina Clemente Conde

Abstract

Tobacco smokers patients present higher prevalence, severity and reincidence of destructive periodontal diseases. The goal of periodontal treatment is to restore tissue health through the elimination and control of etiologic factors, reducing the microbial aggression. Conventional non-surgical therapy consists mainly of scaling and root planning, and emphatic on personal plaque control. Some microorganisms persist in the root surface even after scraping. Thus, the conventional mechanical treatment may fail to reduce the number of periodontal pathogens to levels compatible with health. This fact, together with the impairment of the host system and healing alterations caused by tobacco smoking may explain the worse response shown by these patients. The aim of this study is to verify the effectiveness of the Photodynamic Therapy (PDT) as complementary therapy to non-surgical treatment of chronic periodontitis in tobacco-smoker patients by assessing clinical periodontal parameters. There will be a controlled randomized double-blind split-mouth clinical trial to assess 41 periodontal patients. Individuals with chronic periodontitis will be subjected to conventional periodontal treatment. After seven days of the root surface treatment, bilateral sites with residual pockets (PD e 5 mm) will be selected as experimental sites, and will be randomly allocated to test and control groups. The test group will receive the application of PDT and the control group will receive a sham procedure. The clinical parameters are going to be evaluated at baseline, 7 days, 3, 6, 9 and 12 months after treatment. The collection of sub gingival plaque and gingival crevice fluid is going to be made before PDT, a week after, 6 weeks and 6 and 12 months later. The microbiological evaluation will include the detection and quantification of the periodontal pathogens Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and Aggregatibacter actinomycetencomitans by the polymerase chain in real time (real time PCR). The immunologic evaluation will include the detection of the levels of IL-1, IL-1ß, IL-10 e TNF-± by using enzyme kits (ELISA). During the monitoring period, patients will receive periodontal maintenance every 3 months, as well as the application of PDT or sham procedure in the experimental sites. (AU)