Talebi Mohammadreza, Taliee Rojin, Mojahedi Masoud, Meymandi Mansour, Torshabi Maryam
Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Department of Periodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Periodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Lasers Med Sci. 2016 Spring;7(2):126-30. doi: 10.15171/jlms.2016.21. Epub 2016 Mar 27.
The efficiency of routine scaling and root planning is negatively influenced by the tooth anatomy and residual bacteria all possibly affecting the treatment outcomes in future. The present study compared the microbiologic effectiveness of the photodynamic therapy (PDT) as an adjunctive treatment modality for nonsurgical treatment in chronic periodontitis.
In this randomized controlled clinical trial, 18 chronic periodontitis patients were selected. Four quadrants were randomly treated by scaling and root planning (SRP), diode laser (810n m wavelength, 1.5 W and 320 μm fiber, contact and sweeping technique), SRP + PDT (with diode laser 808 nm, 0.5 W) and laser + SRP (with diode laser 808 nm, 1 W) in each patient. Presence of periodontal pathogen species in the treated areas were measured before the treatment, at 1 and 3 months afterwards. The identification and reproduction of the specific genes of pathogen bacteria were done by means of polymerase chain reaction (PCR) technique. Presence of oral pathogen bacteria in the treatment groups were analyzed by chi-square test. A semi quantitative analysis was used to measure the intensity of white light in each band. This was calculated by number of pixels in each band.
In the qualitative analysis, Fusobacterium nucleatum (Fn) and Treponema denticola (Td) species were killed after 1 month in all treatment modalities. PDT had more effects to decrease Prevotella intermedia (Pi) species than SRP while Tannerella forsythensis count (Tf) species increased in all treatments. Furthermore, Actinobacillus actinomycetemcomitans (Aa) species decreased in all treatments and Porphyromonas gingivalis (P.g) species increased in all treatments after 1 and 3 months.
It can be concluded that PDT was more effective as an adjunctive treatment to SRP than SRP alone; however, no distinct differences were found between both treatment modalities regarding reduction of certain pathogen bacteria.
牙齿解剖结构和残留细菌会对常规龈下刮治和根面平整的效果产生负面影响，所有这些都可能在未来影响治疗结果。本研究比较了光动力疗法（PDT）作为慢性牙周炎非手术治疗辅助手段的微生物学疗效。
在这项随机对照临床试验中，选取了18名慢性牙周炎患者。每位患者的四个象限分别随机接受龈下刮治和根面平整（SRP）、二极管激光（波长810nm，功率1.5W，光纤320μm，接触式扫描技术）、SRP + PDT（二极管激光808nm，功率0.5W）以及激光 + SRP（二极管激光808nm，功率1W）治疗。在治疗前、治疗后1个月和3个月测量治疗区域牙周病原体的存在情况。通过聚合酶链反应（PCR）技术对病原菌的特定基因进行鉴定和复制。采用卡方检验分析治疗组中口腔病原菌的存在情况。使用半定量分析方法测量每个波段的白光强度。这是通过每个波段的像素数量计算得出的。
在定性分析中，所有治疗方式在1个月后均能杀灭具核梭杆菌（Fn）和齿垢密螺旋体（Td）。与SRP相比，PDT对减少中间普氏菌（Pi）的效果更显著，而在所有治疗中福赛坦纳菌（Tf）数量均增加。此外，在1个月和3个月后，所有治疗中伴放线放线杆菌（Aa）数量均减少，牙龈卟啉单胞菌（P.g）数量均增加。
可以得出结论，PDT作为SRP的辅助治疗比单独使用SRP更有效；然而，在减少某些病原菌方面，两种治疗方式之间未发现明显差异。
