Noro Filho Gilberto A, Casarin Renato C V, Casati Márcio Z, Giovani Elcio M
Division of Special Care in Dentistry, Paulista University, São Paulo, São Paulo, Brazil.
Lasers Surg Med. 2012 Apr;44(4):296-302. doi: 10.1002/lsm.22016. Epub 2012 Mar 7.
The aim of this study was to evaluate the clinical and microbiological effect of photodynamic therapy (PDT) in the non-surgical treatment of periodontitis in HIV patients.
Twelve HIV patients from the CEAPE/UNIP, Brazil, with periodontitis were included in this 6-month, split-mouth, double-blind, controlled clinical trial. Patients were placed in the following groups: Group SRP-scaling and root planning with an ultrasonic device (SRP); and Group SRP + PDT-SRP associated with a course of PDT with a diode laser with a wavelength of 660 nm and 0.03 W power associated with methylene blue 0.01% lasting 133 seconds. All clinical measurements (periodontal probing depth (PPD), gingival recession (GR), clinical attachment level (CAL), full-mouth plaque index (FMPI), bleeding score (FMBS)), and microbiological parameters (detection of Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), and Aggregatibacter actinomycetemcomitans (Aa)) were assessed at baseline and at 45 days, and 3 and 6 months after therapy. The ANOVA/Tukey was used for statistical analysis (α = 5%).
There were no differences in any of the investigated parameters observed at baseline in the two groups (P > 0.05). Moreover, participants in the SRP + PDT group presented a higher PPD reduction and CAL gain than those in the SRP group at 45 days and 3 and 6 months. At 6 months, sites receiving SRP + PDT showed a significant PPD reduction of 1.4 ± 0.5 mm, while those in the SRP group showed a 0.3 ± 0.8 mm reduction (P < 0.05). The CAL gain at the sixth month was 1.3 ± 0.5 mm and 0.2 ± 0.7 mm for participants in the SRP + PDT and SRP groups, respectively (P < 0.05). Microbiologically, both therapies presented a reduction in the detection of Pg, Tf, and Aa, and there was no difference between them (P > 0.05).
We concluded that PDT therapy used adjunctively to SRP could promote additional benefits in the treatment of HIV-associated periodontitis.
本研究旨在评估光动力疗法（PDT）在HIV患者牙周炎非手术治疗中的临床和微生物学效果。
来自巴西CEAPE/UNIP的12例患有牙周炎的HIV患者被纳入这项为期6个月的、分口、双盲、对照临床试验。患者被分为以下几组：单纯龈下刮治术组（SRP组），使用超声设备进行龈下刮治和根面平整；以及SRP+PDT组，龈下刮治术联合使用波长660nm、功率0.03W的二极管激光与0.01%亚甲蓝进行为期133秒的光动力治疗疗程。在基线、治疗后45天、3个月和6个月时评估所有临床指标（牙周探诊深度（PPD）、牙龈退缩（GR）、临床附着水平（CAL）、全口菌斑指数（FMPI）、出血评分（FMBS））以及微生物学参数（牙龈卟啉单胞菌（Pg）、福赛坦氏菌（Tf）和伴放线聚集杆菌（Aa）的检测）。采用方差分析/图基检验进行统计分析（α = 5%）。
两组在基线时观察到的任何研究参数均无差异（P > 0.05）。此外，在45天、3个月和6个月时，SRP+PDT组患者的PPD降低幅度和CAL增加幅度均高于SRP组。在6个月时，接受SRP+PDT治疗的部位PPD显著降低1.4±0.5mm，而SRP组降低了0.3±0.8mm（P < 0.05）。SRP+PDT组和SRP组患者在第6个月时的CAL增加量分别为1.3±0.5mm和0.2±0.7mm（P < 0.05）。在微生物学方面，两种治疗方法均使Pg、Tf和Aa的检测率降低，且两者之间无差异（P > 0.05）。
我们得出结论，在SRP基础上辅助使用PDT疗法可在HIV相关性牙周炎治疗中带来额外益处。
