Chondros Panos, Nikolidakis Dimitris, Christodoulides Nicos, Rössler Ralf, Gutknecht Norbert, Sculean Anton
Department of Periodontology, Radboud University Medical Center, Nijmegen, The Netherlands.
Lasers Med Sci. 2009 Sep;24(5):681-8. doi: 10.1007/s10103-008-0565-z. Epub 2008 May 9.
Recent preclinical and clinical data have suggested the potential benefit of photodynamic therapy (PDT) in the treatment of periodontitis. However, currently, there are very limited data from controlled clinical trials evaluating the effect of PDT in the treatment of periodontitis. The aim of the present study was to evaluate the clinical and microbiological effects of the adjunctive use of PDT in non-surgical periodontal treatment in patients receiving supportive periodontal therapy. Twenty-four patients receiving regularly supportive periodontal therapy were randomly treated with either subgingival scaling and root planing followed by a single episode of PDT (test) or subgingival scaling and root planing alone (control). The following parameters were evaluated at baseline and at 3 months and 6 months after therapy: full mouth plaque score (FMPS), full mouth bleeding score (FMBS), bleeding on probing (BOP) at experimental sites, probing pocket depth (PPD), gingival recession (REC), and clinical attachment level (CAL). Primary outcome variables were changes in PPD and CAL. Microbiological evaluation of Aggregatibacter actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g.), Prevotella intermedia (P.i.), Tannerella forsythensis (T.f.), Treponema denticola (T.d.), Peptostreptococcus micros (P.m.), Fusobacterium nucleatum (F.n.), Campylobacter rectus (C.r.), Eubacterium nodatum (E.n.), Eikenella corrodens (E.c.), and Capnocytophaga species (C.s.) was also performed at baseline and at 3 months and 6 months after therapy, using a commercially available polymerase chain reaction test. No differences in any of the investigated parameters were observed at baseline between the two groups. At 3 months and 6 months after treatment, there were no statistically significant differences between the groups in terms of PPD, CAL and FMPS. At 3 months and 6 months, a statistically significantly higher improvement of BOP was found in the test group. At 3 months after therapy, the microbiological analysis showed a statistically significant reduction of F.n. and E.n. in the test group. At 6 months, statistically significantly higher numbers of E.c. and C.s. were detected in the test group. The additional application of a single episode of PDT to scaling and root planing failed to result in an additional improvement in terms of PPD reduction and CAL gain, but it resulted in significantly higher reduction of bleeding scores than following scaling and root planing alone.
近期的临床前和临床数据表明，光动力疗法（PDT）在治疗牙周炎方面具有潜在益处。然而，目前来自对照临床试验评估PDT治疗牙周炎效果的数据非常有限。本研究的目的是评估在接受支持性牙周治疗的患者中，辅助使用PDT在非手术牙周治疗中的临床和微生物学效果。24名接受定期支持性牙周治疗的患者被随机分为两组，一组接受龈下刮治和根面平整，随后进行单次PDT治疗（试验组），另一组仅接受龈下刮治和根面平整（对照组）。在基线、治疗后3个月和6个月评估以下参数：全口菌斑评分（FMPS）、全口出血评分（FMBS）、试验部位探诊出血（BOP）、探诊袋深度（PPD）、牙龈退缩（REC）和临床附着水平（CAL）。主要结局变量是PPD和CAL的变化。在基线、治疗后3个月和6个月，还使用市售聚合酶链反应检测对伴放线聚集杆菌（A.a.）、牙龈卟啉单胞菌（P.g.）、中间普氏菌（P.i.）、福赛坦纳菌（T.f.）、具核梭杆菌（F.n.）、微小消化链球菌（P.m.）、齿垢密螺旋体（T.d.）、直肠弯曲菌（C.r.）、结节真杆菌（E.n.）、腐蚀埃肯菌（E.c.）和二氧化碳嗜纤维菌属（C.s.）进行微生物学评估。两组在基线时所研究的任何参数均未观察到差异。在治疗后3个月和6个月，两组在PPD、CAL和FMPS方面无统计学显著差异。在3个月和6个月时，试验组的BOP改善在统计学上显著更高。治疗后3个月，微生物学分析显示试验组的F.n.和E.n.在统计学上显著减少。在6个月时，试验组检测到的E.c.和C.s.数量在统计学上显著更多。在龈下刮治和根面平整基础上额外进行单次PDT治疗，在减少PPD和增加CAL方面未能带来额外改善，但与单独进行龈下刮治和根面平整相比，出血评分的降低幅度显著更大。
