Department of Periodontology, Swargiya Dadasaheb Kalmegh Smruti (S.D.K.S) Dental College and Hospital, Nagpur, Maharashtra, 440007, India.
Laser Therapy Centre, Department of Surgical and Diagnostic Sciences (D.I.S.C), University of Genoa, Genoa, Italy; Oral Surgery Department, King's College Hospital, Denmark Hill, London, SE5 9RS, UK.
Photodiagnosis Photodyn Ther. 2019 Mar;25:440-447. doi: 10.1016/j.pdpdt.2019.01.023. Epub 2019 Jan 24.
Antimicrobial photodynamic therapy (aPDT) has proved to be an effective adjunctive modality with potential benefits in the management of chronic periodontitis. The combination of photothermal and photodynamic effects of Indocyanine green (ICG) dye, when it is photoactivated with a diode laser of 810 nm wavelength, has been well documented in literature.
This study was conducted to evaluate whether a single session of antimicrobial photodynamic therapy using ICG dye-810 nm diode laser combination can provide a substantial benefit when it is utilised as an adjunct to open flap debridement (OFD) in the management of chronic periodontitis.
Following thorough scaling and root planing, a comparative split mouth randomized controlled clinical trial was carried out on 20 recruited subjects who provided one test (OFD + aPDT) and one control site (OFD alone) each (total 40 treatment sites). The test group was subjected to a single episode of aPDT using ICG photosensitiser dye (1 mg/ml) activated with 810 nm diode laser. The laser was used in a continuous wave, non-contact mode at a power output of 100 mW applied for 30 s/spot (the total of 4 spots per tooth) and delivered by 400 μm fibre, to provide a fluence (energy density) value of 0.0125 J/cm² per spot and generate a total energy of 3 J. The following clinical parameters were assessed at baseline and 3 months: probing pocket depth (PPD), relative attachment level (RAL), relative gingival margin level (RGML), plaque index (PI), gingival index (GI), and gingival bleeding index (GBI). Intragroup and intergroup comparison was performed using paired t-test and independent samples t-test respectively.
Intragroup comparison revealed a statistically significant improvement from baseline visit (p < 0.05). Intergroup comparison showed a statistically significant improvement in RAL, RGML and GI in the test group (p < 0.05).
Utilisation of ICG dye activated with 810 nm diode laser, which mediated aPDT, has demonstrated surplus clinical improvement following OFD in the management of chronic periodontitis.
抗菌光动力疗法（aPDT）已被证明是一种有效的辅助治疗方法，在慢性牙周炎的治疗中具有潜在的益处。文献中已经充分记录了吲哚菁绿（ICG）染料的光热和光动力效应与 810nm 二极管激光相结合的效果。
本研究旨在评估在慢性牙周炎的治疗中，将 ICG 染料-810nm 二极管激光联合的单次抗菌光动力疗法作为翻瓣清创术（OFD）的辅助手段，是否能带来显著的益处。
在彻底的刮治和根面平整后，对 20 名受试者进行了一项对比性、分口随机对照临床试验，每位受试者各有一个试验（OFD+aPDT）和一个对照部位（单独 OFD）（共 40 个治疗部位）。试验组接受单次 ICG 光敏剂染料（1mg/ml）的 aPDT 处理，由 810nm 二极管激光激活。激光以连续波、非接触模式使用，输出功率为 100mW，每个部位照射 30s（每颗牙 4 个部位），采用 400μm 光纤输送，每个部位的能量密度值为 0.0125J/cm²，总能量为 3J。在基线和 3 个月时评估以下临床参数：探诊袋深度（PPD）、相对附着水平（RAL）、相对牙龈缘水平（RGML）、菌斑指数（PI）、牙龈指数（GI）和牙龈出血指数（GBI）。采用配对 t 检验和独立样本 t 检验分别进行组内和组间比较。
组内比较显示，从基线访视开始有统计学意义的改善（p<0.05）。组间比较显示，试验组的 RAL、RGML 和 GI 有统计学意义的改善（p<0.05）。
在慢性牙周炎的治疗中，使用 ICG 染料激活 810nm 二极管激光介导的 aPDT，在 OFD 后显示出了额外的临床改善。
