Division of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
J Periodontol. 2009 Oct;80(10):1568-73. doi: 10.1902/jop.2009.090206.
Periodontitis is a major cause of tooth loss among adults. Several studies have shown a possible systemic impact of periodontal infection, including poor glycemic control in patients with diabetes. Recently, photodynamic therapy (PDT) was used to successfully treat periodontal infection. PDT provides a broad spectrum antimicrobial efficacy with no local or systemic side effects. The objective of this study was to examine the effect of the adjunctive use of PDT on periodontal status and glycemic control of patients with diabetes and periodontitis.
Forty-five patients with type 2 diabetes and moderate to severe chronic periodontitis were selected and randomly assigned to one of the following three treatment modalities (15 subjects each): scaling and root planing (SRP) only, SRP plus systemic doxycycline, and SRP plus PDT. The plaque and bleeding scores, probing depth, clinical attachment level, and glycosylated hemoglobin (HbA1c) level were recorded at baseline and 3 months after periodontal treatment. Descriptive statistics, the paired t test, and analysis of variance (ANOVA) were used for data analysis.
Statistically significant differences in the mean probing depth, clinical attachment level, plaque deposit, and bleeding on probing were found between baseline and 12 weeks post-treatment for all groups. No significant differences in periodontal parameters and glucose levels were detected among the three groups. Reduction in the mean HbA1c level after treatment was observed in all groups but was only significant for the SRP plus doxycycline group.
The results of the present study indicate that PDT does not benefit conventional non-surgical periodontal therapy in patients with diabetes.
牙周炎是成年人牙齿丧失的主要原因。多项研究表明牙周感染可能对全身产生影响，包括糖尿病患者血糖控制不佳。最近，光动力疗法（PDT）已被用于成功治疗牙周感染。PDT 具有广谱抗菌作用，无局部或全身副作用。本研究旨在探讨 PDT 辅助治疗对糖尿病伴牙周炎患者牙周状况和血糖控制的影响。
选择 45 例 2 型糖尿病伴中重度慢性牙周炎患者，随机分为以下三种治疗方式（每组 15 例）：单纯牙周洁治和根面平整术（SRP）、SRP 加全身多西环素和 SRP 加 PDT。在牙周治疗前和治疗后 3 个月记录菌斑指数、出血指数、探诊深度、临床附着水平和糖化血红蛋白（HbA1c）水平。采用描述性统计、配对 t 检验和方差分析（ANOVA）进行数据分析。
所有组的探诊深度、临床附着水平、菌斑沉积和探诊出血的平均评分在治疗前和治疗后 12 周均有统计学差异。三组间牙周参数和血糖水平无显著差异。所有组治疗后 HbA1c 水平均有下降，但仅在 SRP 加多西环素组有统计学意义。
本研究结果表明 PDT 对糖尿病患者的常规非手术牙周治疗没有益处。
