Effects of multiple sessions of antimicrobial photodynamic therapy (aPDT) in the treatment of periodontitis in patients with uncompensated type 2 diabetes: A randomized controlled clinical study

Cláudio, Marina Módolo; Nuernberg, Marta Aparecida Alberton; Rodrigues, João Victor Soares; Belizário, Lícia Clara Garcia; Batista, Júlia Arruda; Duque, Cristiane; Garcia, Valdir Gouveia; Theodoro, Letícia Helena

doi:10.1016/j.pdpdt.2021.102451

Cited by 18 publications

(27 citation statements)

References 60 publications

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“…Several genetic and environmental factors have also been associated with periodontal diseases, including tobacco and alcohol usage, impaired host response, stress, nutrition, osteoporosis, and diabetes ( Pihlstrom et al, 2005 ; Van Dyke and Sheilesh, 2005 ). Research shows that aPDT can be an effective adjunctive treatment in such populations with HIV-associated periodontitis, diabetic patients with periodontitis, smokers and patients undergoing orthodontic treatments with appliances that make plaque control difficult ( Noro Filho et al, 2012 ; Theodoro et al, 2018 ; Alshahrani et al, 2020 ; Cláudio et al, 2021 ).…”

Section: Antimicrobial Photodynamic Therapy and Periodontal And Peri-...mentioning

confidence: 99%

Clinical applications of antimicrobial photodynamic therapy in dentistry

et al. 2023

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Given the emergence of resistant bacterial strains and novel microorganisms that globally threaten human life, moving toward new treatment modalities for microbial infections has become a priority more than ever. Antimicrobial photodynamic therapy (aPDT) has been introduced as a promising and non-invasive local and adjuvant treatment in several oral infectious diseases. Its efficacy for elimination of bacterial, fungal, and viral infections and key pathogens such as Streptococcus mutans, Porphyromonas gingivalis, Candida albicans, and Enterococcus faecalis have been investigated by many invitro and clinical studies. Researchers have also investigated methods of increasing the efficacy of such treatment modalities by amazing developments in the production of natural, nano based, and targeted photosensitizers. As clinical studies have an important role in paving the way towards evidence-based applications in oral infection treatment by this method, the current review aimed to provide an overall view of potential clinical applications in this field and summarize the data of available randomized controlled clinical studies conducted on the applications of aPDT in dentistry and investigate its future horizons in the dental practice. Four databases including PubMed (Medline), Web of Science, Scopus and Embase were searched up to September 2022 to retrieve related clinical studies. There are several clinical studies reporting aPDT as an effective adjunctive treatment modality capable of reducing pathogenic bacterial loads in periodontal and peri-implant, and persistent endodontic infections. Clinical evidence also reveals a therapeutic potential for aPDT in prevention and reduction of cariogenic organisms and treatment of infections with fungal or viral origins, however, the number of randomized clinical studies in these groups are much less. Altogether, various photosensitizers have been used and it is still not possible to recommend specific irradiation parameters due to heterogenicity among studies. Reaching effective clinical protocols and parameters of this treatment is difficult and requires further high quality randomized controlled trials focusing on specific PS and irradiation parameters that have shown to have clinical efficacy and are able to reduce pathogenic bacterial loads with sufficient follow-up periods.

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Section: Antimicrobial Photodynamic Therapy and Periodontal And Peri-...mentioning

confidence: 99%

Clinical applications of antimicrobial photodynamic therapy in dentistry

et al. 2023

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“…For this purpose, 10 individuals were examined twice at an interval of 1 week. 15 PD and clinical attachment level (CAL) analyses were performed in six sites per tooth, and the obtained data were submitted to the Kappa test (0.87).…”

Section: Examiner Calibrationmentioning

confidence: 99%

“…12 Therefore, the use of adjuvant therapies to non-surgical periodontal treatment has been evaluated in the treatment of individuals with poorly controlled DM2. [13][14][15] It is noted that alterations in the repair of oral tissues due to an increased production of reactive oxygen species, TNFα, and advanced glycation end products (AGE) may have effects on these patients. 16 aPDT has been assessed as an adjuvant therapy in the periodontal treatment of patients with DM2.…”

Section: Introductionmentioning

confidence: 99%

“…16 aPDT has been assessed as an adjuvant therapy in the periodontal treatment of patients with DM2. 14,15 aPDT induces a production of singlet oxygen, which can act on bacteria, viruses, protozoa, and fungi. 17 Another recently used adjuvant therapy is the topical application of active oxygen-releasing products in the treatment of periodontitis and peri-implantitis.…”

Section: Introductionmentioning

confidence: 99%

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Association of active oxygen‐releasing gel and photodynamic therapy in the treatment of residual periodontal pockets in type 2 diabetic patients: A randomized controlled clinical study

Cláudio,

Garcia,

Freitas

et al. 2023

Journal of Periodontology

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BackgroundThe aim of this study was to evaluate the effect of active oxygen‐releasing gel as an adjuvant, with and without antimicrobial photodynamic therapy (aPDT), in the treatment of residual pockets in periodontal patients with type 2 diabetes mellitus (DM2).MethodsPatients with residual pockets with probing depth (PD) ≥4 mm and bleeding on probing (BOP) were divided into the following groups: SI (n = 17)—subgingival instrumentation in a single session; BM (n = 17)—SI followed by local application of active oxygen‐releasing gel inside the periodontal pocket for 3 min; BM + aPDT (n = 17)—SI followed by application of BM for 3 min and pocket irrigation with methylene blue, and 660‐nm diode laser irradiation at 100 mW for 50 s. The periodontal clinical parameters, serum levels of glycated hemoglobin, and immunological analysis of crevicular fluid were evaluated. All data were submitted to statistical analysis (α = 5%).ResultsA significant reduction in BOP was verified at 90 and 180 days in the BM + aPDT group. The percentage of sites with PD ≥ 4 mm was significantly reduced at 90 days in BM + aPDT and BM, whereas after 180 days only BM showed a significant reduction. In the BM + aPDT group, there was a significant reduction in tumor necrosis factor α levels at 90 days. There were no differences between the treatments.ConclusionThe use of adjuvant active oxygen‐releasing gel, with or without aPDT, resulted in the same clinical benefits as SI in the treatment of residual pockets in poorly controlled DM2 patients.

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“…Each patient was submitted to a clinical periodontal exams where the following parameters were evaluated: BOP, PD and CAL. PD and CAL were obtained at six sites of every tooth 23,24 . A periodontal probe with 1-mm marks was used (PCPUNC-15, Hu-Friedy, Chicago, IL, USA).…”

Section: Clinical Parametersmentioning

confidence: 99%

LL-37 and hBD-2 in the gingival crevicular fluid of smokers and nonsmokers with periodontitis

Lopes

Colombo

Assem

et al. 2021

Rev. odontol. UNESP

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Introduction The association between smoking and periodontal diseases has been described in clinical and epidemiological studies. Objective The aim of this study was to compare the LL-37 and human β-defensin-2 (hBD-2) levels in crevicular fluid of patients with generalized periodontitis in smokers (S) and nonsmokers (NS). Material and method A total of 35 patients with generalized periodontitis stages III and IV, 15 NS (11 female, 4 male) and 20 S (7 female and 13 male), were included in the study. The evaluated clinical parameters were bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL). Enzyme-linked immunosorbent assays were performed to quantify the LL-37 and hBD-2 levels in the gingival crevicular fluid of these patients. The results were analyzed statistically with the level of significance set at 5%. Result In relation to periodontal clinical parameters, no statistically significant difference was observed for BOP and PD between groups S and NS. There was a higher CAL in the S group than in the NS group (p = 0.0095). There was no statistically significant difference between the levels of LL-37 and hBD-2 when comparing groups S and NS (p>0.05). Conclusion It was concluded that smokers have a higher clinical attachment loss than nonsmokers, but that smoking did not influence the levels of LL-37 and hBD-2 in the gingival crevicular fluid in periodontitis.

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Effects of multiple sessions of antimicrobial photodynamic therapy (aPDT) in the treatment of periodontitis in patients with uncompensated type 2 diabetes: A randomized controlled clinical study

Cited by 18 publications

References 60 publications

Clinical applications of antimicrobial photodynamic therapy in dentistry

Clinical applications of antimicrobial photodynamic therapy in dentistry

Association of active oxygen‐releasing gel and photodynamic therapy in the treatment of residual periodontal pockets in type 2 diabetic patients: A randomized controlled clinical study

LL-37 and hBD-2 in the gingival crevicular fluid of smokers and nonsmokers with periodontitis

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