Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese e Periodontia, Bauru, Brasil.
Universidade de São Paulo, Faculdade de Medicina de Bauru, Bauru, Brasil.
J Appl Oral Sci. 2024 Oct 4;32:e20240258. doi: 10.1590/1678-7757-2024-0258. eCollection 2024.
Antimicrobial photodynamic therapy (aPDT) is an adjuvant treatment to scaling and root planing (SRP) which improves periodontal health. It may be beneficial to patients with systemic diseases, such as type 1 diabetes mellitus.
This randomized clinical trial evaluated the adjunctive effect of aPDT on the periodontal treatment of patients with type 1 diabetes (T1D).
38 patients were included in the study and divided into four groups: DSRP - T1D patients treated with SRP; CSRP - normoglycemic patients treated with SRP; DPDT - T1D patients treated with SRP + aPDT (methylene blue and red laser); CPDT - normoglycemic patients treated with SRP + aPDT. , Periodontal clinical parameters and inflammatory cytokines in crevicular fluid were recorded at baseline and then after 1, 3 and 6 months. The clinical endpoint for treatment was evaluated after 6 months.
Adjuvant aPDT treatment resulted in reduction of probing depth after 3 months (0.38 mm - p<0.05) on T1D patients and in control group after 6 months (0.66 mm - p<0.05). Reduction of clinical attachment levels was similar for both treatments in control patients (p>0.05). There was a significant reduction of TNF-α in crevicular fluid in both groups treated with aPDT (p<0.05). The T1D (65%) and normoglycemic (72%) groups achieved the clinical endpoint after both treatments (p>0.05).
Adjuvant aPDT provided additional benefits in improving periodontal clinical parameters and reducing inflammatory cytokines in both T1D and normoglycemic patients. However, normoglycemic patients showed greater clinical improvements compared to T1D patients following adjuvant aPDT treatment.
抗菌光动力疗法（aPDT）是一种辅助治疗方法，可与龈下刮治和根面平整（SRP）联合使用，以改善牙周健康。它可能对患有 1 型糖尿病等系统性疾病的患者有益。
本随机临床试验评估了 aPDT 对 1 型糖尿病（T1D）患者牙周治疗的辅助作用。
本研究纳入了 38 名患者，并将其分为四组：DSRP-T1D 组：接受 SRP 治疗的 T1D 患者；CSRP-正常血糖组：接受 SRP 治疗的正常血糖患者；DPDT-T1D 组：接受 SRP+aPDT（亚甲蓝和红光激光）治疗的 T1D 患者；CPDT-正常血糖组：接受 SRP+aPDT 治疗的正常血糖患者。在基线时以及之后的 1、3 和 6 个月记录牙周临床参数和龈沟液中的炎症细胞因子。在 6 个月后评估治疗的临床终点。
辅助 aPDT 治疗可使 T1D 患者在治疗后 3 个月时（0.38 毫米，p<0.05）和对照组在治疗后 6 个月时（0.66 毫米，p<0.05）的探诊深度降低。对照组两种治疗方法的临床附着水平降低相似（p>0.05）。两种 aPDT 治疗组龈沟液中的 TNF-α均显著降低（p<0.05）。两种治疗后，T1D 组（65%）和正常血糖组（72%）均达到了临床终点（p>0.05）。
辅助 aPDT 治疗可改善 T1D 和正常血糖患者的牙周临床参数和降低炎症细胞因子，并提供额外的益处。然而，与 T1D 患者相比，正常血糖患者在接受辅助 aPDT 治疗后显示出更大的临床改善。
