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抗菌光动力疗法作为侵袭性牙周炎非手术治疗的辅助手段:一项半口随机对照试验

Antimicrobial photodynamic therapy as an adjunct to non-surgical treatment of aggressive periodontitis: a split-mouth randomized controlled trial.

作者信息

Moreira André L, Novaes Arthur B, Grisi Márcio F, Taba Mario, Souza Sérgio L, Palioto Daniela B, de Oliveira Paula G, Casati Marcio Z, Casarin Renato C, Messora Michel R

机构信息

Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil.

出版信息

J Periodontol. 2015 Mar;86(3):376-86. doi: 10.1902/jop.2014.140392. Epub 2014 Nov 21.

Abstract

BACKGROUND

The management of aggressive periodontitis (AgP) represents a challenge for clinicians because there are no standardized protocols for an efficient control of the disease. This randomized controlled clinical trial evaluated the effects of repeated applications of antimicrobial photodynamic therapy (aPDT) adjunctive to scaling and root planing (SRP) in patients with AgP.

METHODS

Using a split-mouth design, 20 patients with generalized AgP were treated with aPDT + SRP (test group) or SRP only (control group). aPDT was applied at four periods. All patients were monitored for 90 days. Clinical, microbiologic, and immunologic parameters were statistically analyzed.

RESULTS

In deep periodontal pocket analysis (probing depth [PD] ≥ 7 mm at baseline), the test group presented a decrease in PD and a clinical attachment gain significantly higher than the control group at 90 days (P < 0.05). The test group also demonstrated significantly less periodontal pathogens of red and orange complexes and a lower interleukin-1β/interleukin-10 ratio than the control group (P < 0.05).

CONCLUSION

The application of four sessions of aPDT, adjunctive to SRP, promotes additional clinical, microbiologic, and immunologic benefits in the treatment of deep periodontal pockets in single-rooted teeth in patients with AgP.

摘要

背景

侵袭性牙周炎(AgP)的治疗对临床医生而言是一项挑战,因为目前尚无有效控制该疾病的标准化方案。这项随机对照临床试验评估了在侵袭性牙周炎患者中,重复应用抗菌光动力疗法(aPDT)辅助龈下刮治和根面平整(SRP)的效果。

方法

采用半口设计,20例广泛性侵袭性牙周炎患者接受aPDT + SRP治疗(试验组)或仅接受SRP治疗(对照组)。aPDT在四个阶段应用。所有患者均接受90天的监测。对临床、微生物学和免疫学参数进行统计学分析。

结果

在深部牙周袋分析中(基线探诊深度[PD]≥7 mm),试验组在90天时PD降低且临床附着获得显著高于对照组(P < 0.05)。试验组红色和橙色复合体的牙周病原体也显著少于对照组,白细胞介素-1β/白细胞介素-10比值低于对照组(P < 0.05)。

结论

在侵袭性牙周炎患者单根牙深部牙周袋的治疗中,应用四疗程aPDT辅助SRP可带来额外的临床、微生物学和免疫学益处。

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