Petrilli Pedro Henrique, Rodrigues João Victor Soares, Santos Márcio José Possari, Paino-Sant'Ana Amanda, Wainwright Mark, Garcia Valdir Gouveia, de Molon Rafael Scaf, Casarin Renato Corrêa Viana, Theodoro Leticia Helena
Department of Diagnostic and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil.
Department of Diagnostic and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil; Center for Dental Assistance to Persons with Disabilities (CAOE), School of Dentistry, Araçatuba, São Paulo, Brazil.
J Dent. 2025 Aug 25;162:106061. doi: 10.1016/j.jdent.2025.106061.
The aim of this study was to evaluate the use of a single session antimicrobial photodynamic therapy (aPDT) protocol in the re-instrumentation of residual periodontal pockets in individuals with Down Syndrome (DS).
30 individuals with DS and stages I-III grade B periodontitis were allocated into the following groups: SI (n = 17): subgingival instrumentation (SI) in a single session; SI+aPDT (n = 17): SI in single session in residual pockets with probing depth (PD) ≥4 mm and bleeding on probing (BoP), methylene blue irrigation (100 µg/ml) after 60 s, and diode laser irradiation at 100 mW for 50 s. Periodontal clinical parameters PD, BoP, clinical attachment level (CAL) and immunological analysis interleukin (IL)-17, IL-1B, IL-6, IL-8 were evaluated at baseline and on 60 and 90 days. The clinical procedures performed in this study correspond to step 3 periodontal therapy, targeting residual periodontal pockets. All data were submitted to statistical analysis (α=5 %).
A reduction in BoP was observed at 60 and 90 days in the SI+ aPDT group and in the SI group at 90 days. In the SI group, there was a significant reduction in the percentage of PD 4-5 mm at 90 days. Both groups showed a significant reduction in IL-17 levels on 60 and 90 days. The intergroup comparison has revealed no statistically significant differences.
The use of single session aPDT protocol by methylene blue as an adjuvant to non-surgical periodontal treatment in residual periodontal pockets does not promote additional clinical benefits in individuals with DS and periodontitis.
The use of aPDT protocol with methylene blue in the re-instrumentation of residual periodontal pockets does not provide significant clinical advantages in individuals with stage I-III periodontitis and DS. These findings suggest that single-session aPDT may not enhance clinical or immunological outcomes beyond those achieved by conventional subgingival instrumentation alone during the step 3 of periodontal therapy.
本研究旨在评估单次抗菌光动力疗法（aPDT）方案在唐氏综合征（DS）患者残余牙周袋再治疗中的应用。
30例患有I - III期B级牙周炎的DS患者被分为以下几组：SI组（n = 17）：单次龈下刮治术（SI）；SI + aPDT组（n = 17）：对探诊深度（PD）≥4 mm且探诊出血（BoP）的残余牙周袋进行单次SI，60秒后用亚甲蓝冲洗（100 µg/ml），然后用100 mW二极管激光照射50秒。在基线以及第60天和第90天评估牙周临床参数PD、BoP、临床附着水平（CAL）以及免疫分析白细胞介素（IL）-17、IL-1B、IL-6、IL-8。本研究中进行的临床操作对应牙周治疗的第3步，针对残余牙周袋。所有数据均进行统计学分析（α = 5%）。
SI + aPDT组在第60天和第90天以及SI组在第90天观察到BoP减少。在SI组，第90天时4 - 5 mm的PD百分比显著降低。两组在第60天和第90天时IL-17水平均显著降低。组间比较未发现统计学上的显著差异。
在残余牙周袋的非手术牙周治疗中，使用单次aPDT方案并以亚甲蓝作为辅助，对患有DS和牙周炎的患者不会带来额外的临床益处。
在I - III期牙周炎和DS患者的残余牙周袋再治疗中，使用含亚甲蓝的aPDT方案未显示出显著的临床优势。这些发现表明，在牙周治疗的第3步中，单次aPDT可能不会比单纯传统龈下刮治术带来更好的临床或免疫效果。
