Christodoulides Nicos, Nikolidakis Dimitris, Chondros Panagiotis, Becker Jürgen, Schwarz Frank, Rössler Ralf, Sculean Anton
Department of Periodontology, Radboud University Medical Center, Philips van Leydenlaan 25, Nijmegen, The Netherlands.
J Periodontol. 2008 Sep;79(9):1638-44. doi: 10.1902/jop.2008.070652.
Recent preclinical and clinical data have suggested a potential benefit of photodynamic therapy (PDT) in the treatment of periodontitis. However, there are very limited data from controlled clinical trials evaluating the effect of PDT in the treatment of periodontitis. The aim of this study was to evaluate the clinical and microbiologic effects of the adjunctive use of PDT to non-surgical periodontal treatment.
Twenty-four subjects with chronic periodontitis were randomly treated with scaling and root planing followed by a single episode of PDT (test) or scaling and root planing alone (control). Full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing depth (PD), gingival recession, and clinical attachment level (CAL) were measured at baseline and 3 and 6 months after therapy. Primary outcome variables were changes in PD and CAL. Microbiologic evaluation of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia (previously T. forsythensis), Treponema denticola, Parvimonas micra (previously Peptostreptococcus micros or Micromonas micros), Fusobacterium nucleatum, Campylobacter rectus, Eubacterium nodatum, Eikenella corrodens, and Capnocytophaga spp. was performed at baseline and 3 and 6 months following therapy by using a commercially available polymerase chain reaction test.
At 3 and 6 months after treatment, there were no statistically significant differences between the groups with regard to CAL, PD, FMPS, or microbiologic changes. At 3 and 6 months, a statistically significantly greater improvement in FMBS was found 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 PD reduction and CAL gain, but it resulted in a significantly higher reduction in bleeding scores compared to scaling and root planing alone.
近期的临床前和临床数据表明,光动力疗法(PDT)在治疗牙周炎方面可能具有益处。然而,评估PDT治疗牙周炎效果的对照临床试验数据非常有限。本研究的目的是评估PDT辅助非手术牙周治疗的临床和微生物学效果。
24名慢性牙周炎患者被随机分为两组,一组接受龈上洁治和根面平整后进行单次PDT治疗(试验组),另一组仅接受龈上洁治和根面平整(对照组)。在基线以及治疗后3个月和6个月时,测量全口菌斑评分(FMPS)、全口出血评分(FMBS)、探诊深度(PD)、牙龈退缩和临床附着水平(CAL)。主要结局变量为PD和CAL的变化。在基线以及治疗后3个月和6个月时,使用市售聚合酶链反应检测法对伴放线聚集杆菌(以前称为伴放线放线杆菌)、牙龈卟啉单胞菌、中间普氏菌、福赛坦纳菌(以前称为福赛坦氏菌)、具核梭杆菌、微小微单胞菌(以前称为微小消化链球菌或微小单胞菌)、直杆弯曲菌、结节真杆菌、腐蚀埃肯菌和二氧化碳嗜纤维菌属进行微生物学评估。
治疗后3个月和6个月时,两组在CAL、PD、FMPS或微生物学变化方面无统计学显著差异。在3个月和6个月时,试验组的FMBS改善在统计学上显著更大。
在龈上洁治和根面平整基础上额外应用单次PDT,在减少PD和增加CAL方面未能带来额外改善,但与单纯龈上洁治和根面平整相比,出血评分的降低显著更高。