One-Year Clinical, Microbiological and Immunological Results of Local Doxycycline or Antimicrobial Photodynamic Therapy for Recurrent/Persisting Periodontal Pockets: A Randomized Clinical Trial

Abstract

We evaluated, in this study, the clinical, microbiological and immunological effects of local drug delivery (LDD) or photodynamic therapy (PDT), adjunctive to subgingival instrumentation (SI) in persistent or recurrent periodontal pockets in patients enrolled in supportive periodontal therapy (SPT) after one year. A total of 105 patients enrolled in SPT with persistent/recurrent pockets were randomly treated with SI +PDT or SI + LDD or SI (control). The number of treated sites with bleeding on probing (n BOP+), probing pocket depths (PPD), clinical attachment level (CAL), full-mouth plaque and bleeding scores (gingival bleeding index, %bleeding on probing-BOP) was evaluated at baseline and after 12 months. Additionally, eight periodontopathogens and the immunomarkers IL-1β (interleukin)and MMP-8 (matrix metalloprotease) were quantitatively determined using real-time PCR and ELISA, respectively. All three treatments resulted in statistically significant clinical improvements (p < 0.05) without statistically significant intergroup differences (p > 0.05), which were maintained up to 12 months. The presence of BOP negatively affected the PPD and CAL. Moreover, statistically significantly fewer bleeding sites at 12 months were observed in the test groups (p = 0.049). Several periodontopathogens were reduced after 12 months. In conclusion, the present data indicate that in periodontal patients enrolled in SPT, treatment of persistent/recurrent pockets with SI alone or combined with either PDT or LDD may lead to comparable clinical, microbiological and immunological improvements, which are maintained up to 12 months. Secondly, the presence of BOP directly impacts the PPD and CAL.

Efficacy of photodynamic therapy as an adjunct to scaling and root planing on clinical parameters and microbial composition in subgingival plaque of periodontitis patients: A split‐mouth randomized clinical trial

“…found that repeated PDT could reduce A. actinomycetemcomitans , Tannerella forsythia , and T. denticola in 4–6‐mm pockets and T. denticola in pockets >6 mm at 6 months. However, in a long‐term study, no significant reduction of periodontopathogens was observed in the group that accepted one time of PDT 47 . In our study, repeated PDT showed a more durable and powerful effect than single PDT.…”

Photodynamic Therapy with Tolonium Chloride and a Diode Laser (635 nm) in the Non-Surgical Management of Periodontitis: A Clinical Study

“…This excited photosensitizer, possessing a longer life-time compared to ordinary reactive oxygen species (ROS), interacts with the surrounding molecules. In its triplet state, a cascade of reactions occur, leading to the generation of cytotoxic species [ 33 , 34 ]. Two distinct pathways have been proposed for the reactions of the triplet state: Type I and Type II [ 23 ].…”

“…These free-radical species further interact with endogenous molecular oxygen, resulting in the production of highly reactive oxygen species, including superoxide, hydroxyl radicals, and hydrogen peroxide. These reactive oxygen species essentially “attack” the cell membrane, causing its disintegration and leading to irreversible biological damage [ 23 , 33 , 34 ]. On the other hand, Type II reaction involves the direct interaction of the triplet state photosensitizer with molecular oxygen.…”

Photoinactivation and Photoablation of Porphyromonas gingivalis

“…Among the photosensitizers examined in research involving Pg , the most extensively studied to date have been indocyanine green [ 91 , 92 , 93 ], methylene blue [ 94 , 95 , 96 ] and toluidine blue [ 97 , 98 , 99 ]. Other photosensitizers have included: aminolevulinic acid [ 100 ], azulene [ 101 ], β-NaYF 4 :Yb 3+ , Tm 3+ @TiO 2 (termed UCNPs@TiO 2 ) [ 102 ], BLC 1010 and BLC 1014 [ 103 ], cadmium telluride nanocrystals [ 104 ], captopril-protected gold clusters [ 105 ], cationic amino acid-porphyrin conjugate 4i [ 106 ], Chlorin-e6 [ 103 , 107 , 108 ], chloro-aluminum phthalocyanine [ 109 , 110 ], Coumarin 6 [ 111 ], Curcumin [ 112 , 113 ], curcumin-NP [ 114 ], cyanidin-3-glucoside [ 115 ], doxycycline [ 116 ], erythrosine [ 115 , 117 ], graphene silver polymethyl methacrylate [ 118 ], lysine-porphyrin conjugate 4i [ 119 ], meta-tetra(hydroxyphenyl)chlorin (mTHPC) [ 120 ], oxyhemoglobin-based oxyHb@IR820 [ 121 ], phenothiazine chloride [ 122 , 123 , 124 ], phloxine B [ 125 ], Photodithazine [ 126 ], phycocyanin [ 127 ], protoporphyrin IX [ 35 ], purpurin-based photosensitizer [ 128 ], Radac...…”