Corrêa Mônica Grazieli, Oliveira Deborah Haydee, Saraceni Cintia Helena Coury, Ribeiro Fernanda Vieira, Pimentel Suzana Peres, Cirano Fabiano Ribeiro, Casarin Renato Corrêa Viana
Dental Research Division, School of Dentistry, Paulista University, São Paulo, São Paulo, Brazil.
Lasers Surg Med. 2016 Dec;48(10):944-950. doi: 10.1002/lsm.22449. Epub 2015 Dec 10.
Photodynamic therapy (PDT) has been used as a therapeutic alternative to treat periodontitis, especially in challenging sites that require additional periodontal therapy such as residual pockets. The aim of this split-mouth randomized trial was to evaluate the microbiological and clinical effects of PDT on non-surgical treatment of unresponsive pockets.
STUDY DESIGN/MATERIALS AND METHODS: A split-mouth, randomized controlled clinical trial was conducted in 15 patients presenting at least two residual pockets (probing pocket depth [PPD] ≥5 mm with bleeding on probing [BoP]) in single-rooted teeth in supportive periodontal therapy. The selected sites randomly received: (1) SRP + PDT: scaling and root planing combined with photodynamic therapy (methylene blue as a photosensitizer), or (2) SRP: scaling and root planing alone. The concentrations of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans were evaluated using a Real-time PCR technique at baseline and 3, 7, 14, and 90 days. Clinical parameters were assessed at baseline and 3 months post-therapies.
Both treatments promoted clinical improvements, with additional benefits to the SRP + PDT group in PPD reduction and clinical attachment level gain (P < 0.05) after 3 months. Only the SRP + PDT group exhibited a statistically significant reduction in the levels of A. actinomycetemcomitans on the 3rd and 7th days after therapy (P < 0.05), and a lower concentration of this pathogen was detected at 7 days in the SRP + PDT group when compared to the other therapy (P < 0.05).
The combined therapeutic approach SRP + PDT may reduce A. actinomycetemcomitans levels for a short-term period, associated with additional improvement in clinical parameters in treating residual pockets. Lasers Surg. Med. 48:944-950, 2016. © 2015 Wiley Periodicals, Inc.
光动力疗法（PDT）已被用作治疗牙周炎的一种替代疗法，尤其适用于需要额外牙周治疗的挑战性部位，如残留牙周袋。这项半口随机试验的目的是评估光动力疗法对无反应性牙周袋非手术治疗的微生物学和临床效果。
研究设计/材料与方法：对15例在支持性牙周治疗中单根牙至少有两个残留牙周袋（探诊深度[PPD]≥5毫米且探诊出血[BoP]）的患者进行了半口随机对照临床试验。所选部位随机接受：（1）SRP + PDT：龈下刮治和根面平整联合光动力疗法（亚甲蓝作为光敏剂），或（2）SRP：仅龈下刮治和根面平整。在基线以及第3、7、14和90天时，使用实时聚合酶链反应技术评估牙龈卟啉单胞菌和伴放线聚集杆菌的浓度。在基线和治疗后3个月评估临床参数。
两种治疗方法均促进了临床改善，3个月后，SRP + PDT组在PPD降低和临床附着水平增加方面有额外益处（P < 0.05）。仅SRP + PDT组在治疗后第3天和第7天伴放线聚集杆菌水平有统计学显著降低（P < 0.05），与其他治疗方法相比，SRP + PDT组在第7天时该病原体浓度更低（P < 0.05）。
联合治疗方法SRP + PDT可能在短期内降低伴放线聚集杆菌水平，同时在治疗残留牙周袋时临床参数有额外改善。《激光外科与医学》48:944 - 950，2016年。© 2015威利期刊公司
