Al-Khureif Abdulaziz Abdullah, Mohamed Badreldin A, Siddiqui Adel Zia, Khan Aftab Ahmed, Divakar Darshan Devang
Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
Community Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
Photodiagnosis Photodyn Ther. 2020 Mar;29:101610. doi: 10.1016/j.pdpdt.2019.101610. Epub 2019 Nov 27.
To evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) and antimicrobial therapy on clinical and immunological outcomes of periodontal treatment in patients with periodontitis grade C and stage III or IV.
The patients recruited in the current research fulfil the clinical case definition of periodontitis 'grade C' in terms of onset of the infection and stage III or IV that defines degree and severity of the disease. One-stage full-mouth ultrasonic debridement (UD) was performed and randomly divided in two groups: Group-I - four applications of aPDT, and Group-II - combination of metronidazole (MTZ) and amoxicillin (AMX) 3 tablets each for 7 days. Whole-mouth periodontal parameters were recorded at baseline, 3-, 6-months after completion of treatment. Gingival crevicular fluid samples were obtained for assessment of inflammatory interleukin (IL)-10 and IL-17 at the same time points.
Seventeen healthy patients completed the study protocol and revealed similar clinical findings at baseline. Bleeding scores significantly reduced in group-I at 3 months post treatment (p < 0.05). It could be seen that group-I showed statistically significant reduction of deep periodontal pockets and gain in CAL in patients with GAP at 3 months (p < 0.05). This difference was maintained at 6 months of follow-up (p < 0.001). Group-II was capable of increasing the levels of IL-10 and reducing IL-17 in GCF at both time periods compared to Group-I (p < 0.05). Group-I did not have significant effect on either cytokine levels in GCF (p > 0.05).
Antimicrobial photodynamic therapy improved severe deep periodontal pockets. However, the combination of antimicrobial therapy helped in reducing proinflammation in grade C and stage III or IV periodontitis.
评估抗菌光动力疗法（aPDT）和抗菌疗法对C级、III期或IV期牙周炎患者牙周治疗的临床和免疫结局的疗效。
本研究招募的患者在感染发作方面符合牙周炎“C级”的临床病例定义，且在疾病程度和严重程度方面符合III期或IV期定义。进行了一期全口超声清创术（UD），并随机分为两组：第一组——进行4次aPDT治疗，第二组——甲硝唑（MTZ）和阿莫西林（AMX）各3片联合使用，持续7天。在基线、治疗完成后3个月和6个月记录全口牙周参数。在相同时间点采集龈沟液样本，以评估炎症性白细胞介素（IL）-10和IL-17。
17名健康患者完成了研究方案，且在基线时显示出相似的临床结果。治疗后3个月，第一组的出血评分显著降低（p < 0.05）。可以看出，第一组在3个月时，有牙龈附着丧失（GAP）的患者深牙周袋有统计学意义的减少，临床附着水平（CAL）增加（p < 0.05）。这种差异在随访6个月时仍保持（p < 0.001）。与第一组相比，第二组在两个时间段均能提高龈沟液中IL-10水平并降低IL-17水平（p < 0.05）。第一组对龈沟液中两种细胞因子水平均无显著影响（p > 0.05）。
抗菌光动力疗法改善了严重的深牙周袋。然而，抗菌疗法的联合应用有助于减轻C级、III期或IV期牙周炎的炎症。
