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单次抗菌光动力疗法作为非手术牙周刮治和根面平整的辅助治疗,是否能有效减少牙周炎患者的牙周炎症和龈下牙龈卟啉单胞菌和伴放线放线杆菌的存在?

Is a single session of antimicrobial photodynamic therapy as an adjuvant to non-surgical scaling and root planing effective in reducing periodontal inflammation and subgingival presence of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans in patients with periodontitis?

机构信息

Department of Biology, College of Science, Princess Nourah Bint Abdul Rahman University, Riyadh, Saudi Arabia.

Department of Botany and Microbiology, College of Science, Princess Nourah Bint Abdul Rahman University, Riyadh, Saudi Arabia.

出版信息

Photodiagnosis Photodyn Ther. 2022 Jun;38:102847. doi: 10.1016/j.pdpdt.2022.102847. Epub 2022 Mar 31.

Abstract

OBJECTIVE

The aim was to assess the influence of a single session of antimicrobial photodynamic therapy (aPDT) as an adjunct to non-surgical scaling and root planing (SRP) in reducing periodontal inflammation and subgingival presence of Porphyromonas gingivalis (P. gingivalis) and Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) in patients with periodontitis.

METHODS

Patients diagnosed with periodontitis were included. Information regarding age and gender was recorded using a questionnaire. All patients underwent full mouth non-surgical SRP and the following parameters were assessed at baseline: (a) marginal bone loss (MBL); (b) probing depth (PD) (c) clinical attachment loss (CAL); and (d) presence of supra-and subgingival bleeding and plaque (GI and PI). Identification of A. actinomycetemcomitans and P. gingivalis was performed using polymerase chain reaction. For aPDT (test-group), methylene-blue (MB) (0.005%) was used as photosensitizer and it was applied over and inside the buccal pockets of teeth. Using a Diode laser at 660 nm and 150 mW, irradiation was performed All clinical parameters except for MBL and microbiological evaluations were re-assessed at 3-months of follow-up. Level of significance was set at P<0.05.

RESULTS

At 3-months of follow-up A. actinomycetemcomitans and P. gingivalis were identified in significantly lower number of patients in groups 1 and 2 compared with their respective baseline values. Number of patients in whom A. actinomycetemcomitans and P. gingivalis were identified at 3-months of follow-up were similar in both groups. At baseline, there was no statistically significant difference in PI, GI, PD, CAL and MBL among patients in groups 1 and 2. In groups 1 and 2, scores of PI (P<0.001), GI (P<0.001) and PD (P<0.001) were significantly higher at baseline compared with their respective 3-months' follow-up scores.

CONCLUSION

One application of aPDT with non-surgical SRP is ineffective in managing periodontal inflammation and presence of P. gingivalis and A. actinomycetemcomitans in periodontitis patients.

摘要

目的

评估单次抗菌光动力疗法(aPDT)作为非手术刮治和根面平整(SRP)辅助治疗在减少牙周炎患者牙周炎症和龈下牙龈卟啉单胞菌(P. gingivalis)和伴放线放线杆菌(A. actinomycetemcomitans)方面的影响。

方法

纳入诊断为牙周炎的患者。使用问卷记录年龄和性别信息。所有患者均行全口非手术 SRP,并在基线时评估以下参数:(a)边缘骨丧失(MBL);(b)探诊深度(PD);(c)临床附着丧失(CAL);(d)龈上和龈下出血和菌斑(GI 和 PI)的存在情况。使用聚合酶链反应(PCR)鉴定 A. actinomycetemcomitans 和 P. gingivalis。对于 aPDT(实验组),使用亚甲蓝(MB)(0.005%)作为光敏剂,并将其涂于和涂于颊侧袋内的牙齿上。使用 660nm 和 150mW 的二极管激光进行照射。所有临床参数(MBL 和微生物学评估除外)均在 3 个月随访时重新评估。设定显著性水平为 P<0.05。

结果

在 3 个月的随访中,与基线值相比,第 1 组和第 2 组的患者中 A. actinomycetemcomitans 和 P. gingivalis 的数量明显减少。在第 1 组和第 2 组中,在 3 个月随访时鉴定出 A. actinomycetemcomitans 和 P. gingivalis 的患者数量相似。在基线时,第 1 组和第 2 组患者的 PI、GI、PD、CAL 和 MBL 无统计学差异。在第 1 组和第 2 组中,PI(P<0.001)、GI(P<0.001)和 PD(P<0.001)评分在基线时均明显高于各自 3 个月的随访评分。

结论

单次 aPDT 联合非手术 SRP 不能有效治疗牙周炎患者的牙周炎症和龈下 P. gingivalis 和 A. actinomycetemcomitans 的存在。

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