Department of Periodontics SRM Dental College, Ramapuram, Chennai, 600089, Tamilnadu, India.
Photodiagnosis Photodyn Ther. 2020 Sep;31:101949. doi: 10.1016/j.pdpdt.2020.101949. Epub 2020 Aug 5.
The clinical efficacy of multiple applications of Photodynamic therapy (PDT) needs to be better investigated for the management of chronic periodontitis subjects.
The aim of this study was to evaluate the clinical and antimicrobial efficacy of multiple application of PDT as an adjunct to scaling and root planning in management of moderate periodontal pockets.
33 patients with bilateral periodontal destruction in mandibular posterior sextants were randomly treated with either test (SRP + multiplePDT) or control (SRP) intervention. PDT was employed with diode laser(810 nm) and Indocyanine green(ICG) dye at baseline, 1 st, 2nd and 4th week post SRP. Probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), gingival bleeding index (GBI) were recorded at baseline, 3 and 6 months. Subgingival plaque samples were analysed for Porphyromonas gingivalis (P.g), Aggregatibacter actinomycetemcomitans (A.a), Tannerella forsythia (T.f), Fusobacterium nucleatum (F.n), Treponema denticola (T.d).
Statistically significant improvement was noted in all clinical parameters in both the groups from baseline to 3 and 6 months. The mean PPD and CAL decreased in control sites from 5.83 ± 0.64 and 5.60 ± 0.72 at baseline to 3.80 ± 0.40 and 3.70 ± 0.91 at 6 months and in test sites from 5.93 ± 0.82 and 5.73 ± 0.69 to 3.40 ± 0.56 and 3.00 ± 0.91 at 6 months (P ≤ 0.05). Test sites showed significantly greater reduction in P.g, A.a, T.f, F.n and T.d compared to control sites at 3 and 6 months (P ≤ 0.05).
The outcomes suggested that adjunctive multiple applications of PDT to SRP shows significant reduction in periodontal pathogens over SRP alone.
为了更好地治疗慢性牙周炎患者，需要进一步研究光动力疗法（PDT）多次应用的临床疗效。
本研究旨在评估 PDT 多次应用作为牙周刮治和根面平整辅助治疗的临床和抗菌疗效，用于治疗中度牙周袋。
33 名下颌后牙区双侧牙周破坏的患者被随机分为试验组（SRP+多次 PDT）和对照组（SRP）。在 SRP 后基线、第 1 周、第 2 周和第 4 周，采用二极管激光（810nm）和吲哚菁绿（ICG）染料进行 PDT。在基线、3 个月和 6 个月时记录探诊袋深（PPD）、临床附着水平（CAL）、菌斑指数（PI）、牙龈指数（GI）、牙龈出血指数（GBI）。分析龈下菌斑样本中牙龈卟啉单胞菌（P.g）、伴放线放线杆菌（A.a）、福赛斯坦纳菌（T.f）、核梭杆菌（F.n）、中间普氏菌（T.d）的含量。
两组患者的所有临床参数均从基线至 3 个月和 6 个月时均有显著改善。对照组的平均 PPD 和 CAL 从基线时的 5.83 ± 0.64 和 5.60 ± 0.72 分别降低至 6 个月时的 3.80 ± 0.40 和 3.70 ± 0.91，试验组从基线时的 5.93 ± 0.82 和 5.73 ± 0.69 分别降低至 6 个月时的 3.40 ± 0.56 和 3.00 ± 0.91（P≤0.05）。试验组在 3 个月和 6 个月时与对照组相比，Pg、A.a、T.f、F.n 和 T.d 的减少量显著更大（P≤0.05）。
结果表明，与单独的牙周刮治和根面平整相比，牙周刮治和根面平整联合多次 PDT 可显著减少牙周致病菌。
