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抗菌光动力疗法对 2 型糖尿病患者牙周病和血糖控制的影响。

The effect of antimicrobial photodynamic therapy on periodontal disease and glycemic control in patients with type 2 diabetes mellitus.

机构信息

Department of Oral Medicine and Periodontology, University Medical Center Ljubljana, Ljubljana, Slovenia.

Community Health Centre Murska Sobota, Murska Sobota, Slovenia.

出版信息

Clin Oral Investig. 2023 Oct;27(10):6235-6244. doi: 10.1007/s00784-023-05239-0. Epub 2023 Sep 6.

Abstract

OBJECTIVES

This study is aimed at determining the effect of concomitant antimicrobial photodynamic therapy (aPTD) on periodontal disease and glycaemic control in patients with type 2 diabetes mellitus (T2DM).

MATERIALS AND METHODS

Twenty-four patients with T2DM were enrolled in the study. Periodontal clinical parameters were assessed by measuring probing pocket depth (PPD), clinical attachment loss (CAL), gingival recession (GR), full-mouth bleeding score (FMBS), full-mouth plaque score (FMPS), and full-mouth sulcus bleeding score (FMSBS). Glycated haemoglobin A1c (HbA1c) was measured. To determine the presence of the following periodontal pathogenic bacteria, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, subgingival plaque samples were taken from two periodontal pockets per jaw with the greatest PPD using paper tips. Patients were randomly divided into the test and control group. In the test group, full-mouth disinfection was performed in combination with aPTD. In the control group, only full-mouth disinfection was performed.

RESULTS

The results showed an improvement in periodontal clinical parameters in both groups. The difference between the groups in favour of the test group was statistically significant for BOP. The HbA1c level decreased in both groups. The difference was not statistically significant. The results of the microbiological analysis suggest that the presence of periodontal pathogenic bacteria is lower with additional antimicrobial photodynamic therapy with statistically significant difference for T. forsythia.

CONCLUSIONS

Additional aPDT causes a significant reduction in BoP in the proportion of positive sites for periodontal pathogens.

TRIAL REGISTRATION

ClinicalTrials.gov ID: NCT05816941.

CLINICAL RELEVANCE

aPTD is a noninvasive adjunctive therapy that can positively influence the periodontal treatment outcome.

摘要

目的

本研究旨在确定伴用抗菌光动力疗法(aPTD)对 2 型糖尿病(T2DM)患者牙周病和血糖控制的影响。

材料和方法

本研究纳入了 24 例 T2DM 患者。通过测量探诊牙周袋深度(PPD)、临床附着丧失(CAL)、牙龈退缩(GR)、全口出血评分(FMBS)、全口菌斑评分(FMPS)和全口龈沟出血评分(FMSBS)评估牙周临床参数。测量糖化血红蛋白 A1c(HbA1c)。使用纸尖从每个颌部两个牙周袋中采集探诊牙周袋深度最大的龈下菌斑样本,以确定以下牙周致病菌的存在:伴放线放线杆菌、中间普氏菌、牙龈卟啉单胞菌、福赛坦纳菌和牙髓密螺旋体。患者被随机分为试验组和对照组。在试验组中,进行全口消毒联合 aPTD。在对照组中,仅进行全口消毒。

结果

结果显示,两组的牙周临床参数均有所改善。在 BOP 方面,组间差异对试验组有利,具有统计学意义。两组的 HbA1c 水平均降低。差异无统计学意义。微生物分析结果表明,在牙周致病菌阳性部位,联合使用抗菌光动力疗法后,牙周致病菌的存在率较低,差异具有统计学意义。

结论

附加的 aPDT 可显著降低牙周病致病菌阳性部位的 BOP。

试验注册

ClinicalTrials.gov 标识符:NCT05816941。

临床相关性

aPTD 是一种非侵入性的辅助治疗方法,可对牙周治疗结果产生积极影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e12c/10560165/f0fc8fe5431d/784_2023_5239_Fig1_HTML.jpg

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