Treatment of chronic periodontitis with multiple episodes of antimicrobial photodynamic therapy (aPDT) or amoxicillin and metronidazole: A randomized clinical study

Author(s)

Alessandra Barreto Lopes

• Document type: Master's Dissertation
• Press: Araçatuba. 2016-09-28.
• Institution: Universidade Estadual Paulista (Unesp). Faculdade de Odontologia. Araçatuba
• Defense date: 2016-09-19
• Advisor: Leticia Helena Theodoro; Cristiane Duque

Abstract

Aim: This study compared, through clinical analysis, the effects of Amoxicillin associated with metronidazole (MTZ+AMX), and multiple applications of antimicrobial photodynamic therapy (aPDT), as adjuncts therapy in the treatment of chronic periodontitis. Methods: A controlled randomized clinical trial was conducted in 34 patients, divided into two groups: the MTZ+AMX Group (n=17), subjected to scaling and root planing (SRP) with systemic use of Metronidazole (400 mg 3 X per day 7 days) and Amoxicillin (500 mg 3 X per day 7 days); and the aPDT Group (n=17), submitted to SRP and three aPDT applications in all sites with a probing depth larger than 4 mm, immediately 48 and 96 hours after scaling, and placebo during 7 days. Clinical examinations were performed at the baseline, 3 and 6 months post-therapy. The clinical parameters visible plaque index (VPI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were measured. The aPDT was carried out using methylene blue (10 mg/mL) and the Gallium-Aluminum-Arsenide (GaAlAs) laser at 1 minute (660 nm, 100 mW, 48 seconds, 160 J/cm²) 48 and 96 hours immediately after treatment, in all sites with a probing deeper than 4 mm. Subsequently, statistical analysis was performed (α=5%). Results: Intragroup analysis did not reveal statistically significant differences between mean mouth in PD in all three stages of the study in either groups. In addition, there were no statistically significant differences in PD between the groups in each period (P>0.05). With regard to the CAL both groups there was a statistically significant gain at 90 days compared to the baseline (P<0.05). In both groups there was a reduction in BOP and the percentage of residual pockets after 90 and 180 days compared to the baseline (P<0.05). Conclusion: Both adjunct therapies have proven effective in the treatment of chronic periodontitis, promoting a reduction of periodontal tissue inflammation, clinical attachment gain and reducing the number of residual pockets. (AU)

• FAPESP's process: 14/11637-2 - Treatment of chronic periodontitis with multiple episodes of antimicrobial photodynamic therapy (aPDT) or systemic use of amoxicillin and metronidazole: randomized clinical trial
• Grantee: Alessandra Barreto Lopes
• Support Opportunities: Scholarships in Brazil - Master