Photodynamic Therapy During Supportive Periodontal Care: Clinical, Microbiologic, Immunoinflammatory, and Patient-Centered Performance in a Split-Mouth Randomized Clinical Trial

Autor(es)

Kolbe, Maria F. ^[1] ; Ribeiro, Fernanda V. ^[1] ; Luchesi, Vanessa H. ^[1] ; Casarin, Renato C. ^[1] ; Sallum, Enilson A. ^[2] ; Nociti, Jr., Francisco H. ^[2] ; Ambrosano, Glaucia M. B. ^[3] ; Cirano, Fabiano R. ^[1] ; Pimentel, Suzana P. ^[1] ; Casati, Marcio Z. ^[1]

Afiliação do(s) autor(es)

^[1] Univ Paulista, Sch Dent, Dent Res Div, Sao Paulo - Brazil

^[2] Univ Estadual Campinas, Sch Dent Piracicaba, Dept Prosthodont & Periodont, Sao Paulo - Brazil

^[3] Univ Estadual Campinas, Sch Dent Piracicaba, Dept Social Dent Stat, Campinas, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: Journal of Periodontology; v. 85, n. 8, p. E277-E286, AUG 2014.
• Citações Web of Science: 31

Resumo

Background: This study investigates the effect of photodynamic therapy (PDT) as monotherapy during supportive periodontal therapy. Methods: A split-mouth, randomized controlled trial was conducted in patients with chronic periodontitis (N = 22) presenting at least three residual pockets (probing depth {[}PD] >= 5 mm with bleeding on probing {[}BOP]). The selected sites randomly received the following: 1) PDT; 2) photosensitizer (PS); or 3) scaling and root planing (SRP). At baseline and 3 and 6 months, clinical, microbiologic (real-time polymerase chain reaction analyses), cytokine pattern (multiplexed bead immunoassay), and patient-centered (regarding morbidity) evaluations were performed. Results: All therapies promoted similar improvements in clinical parameters throughout the study (P <0.05), except that BOP was not reduced in the PS protocol (P >0.05). Lower levels of Aggregatibacter actinomycetemcomitans were observed in the PDT and SRP protocols at 3 months when compared with the PS protocol (P <0.05). An inferior frequency detection of Porphyromonas gingivalis was observed in the PDT protocol at 3 and 6 months and in the SRP protocol at 6 months from baseline (P <0.05). In addition, PDT protocol presented inferior frequency of P. gingivalis at 3 months when compared with the other therapies (P <0.05). Only patients in the PDT protocol exhibited augmented levels of anti-inflammatory interleukin (IL)-4 and reduced proinflammatory IL-1 beta and IL-6 throughout the study (P <0.05). Intergroup analyses showed reduced IL-10 and increased interferon-gamma and IL-1 beta levels in the PS protocol when compared with the other therapies during follow-ups (P <0.05). No differences in morbidity were observed between the therapies (P >0.05), although the need for anesthesia was higher in SRP-treated sites (P <0.05). Conclusion: PDT as an exclusive therapy may be considered a non-invasive alternative for treating residual pockets, offering advantages in the modulation of cytokines. (AU)

• Processo FAPESP: 10/51218-8 - Terapia fotodinamica no tratamento da doenca periodontal. avaliacao clinica, microbiologica e imunoenzimatica.
• Beneficiário: Márcio Zaffalon Casati
• Modalidade de apoio: Auxílio à Pesquisa - Regular