Peran photodynamic therapy dalam perawatan periodontal non-bedah

Abstract

Introduction: The main of non-surgical periodontal treatment is mechanical debridement. However, the treatment success rate is greatly influenced by ease of mechanical instrument access. Therefore, adjunctive antimicrobial therapy is indicated for complete removal of periodontal pathogen. Since long term systemic antimicrobial treatment can cause resistency, local antimicrobial treatment such as photodynamic therapy may serve as a better choice. Literature review: Photodynamic therapy (PDT) consists of 3 elements: photosensitizer, oxygen, and visible light. After photosensitizer binds with target cells, they are activated by visible light with suitable wavelength, thus producing singlet oxygen and Reactive Oxygen Species (ROS) to create toxic environment for anaerobic periodontal pathogen. PDT increases clinical attachment gain in both chronic and aggressive periodontitis treatment. It also decreases bleeding on probing and pocket depth. Discussion: The advantages of PDT are non invasive, short treatment time required, and reduced possibility of antimicrobial resistency. The disadvantages of PDT are tissue thermogenesis effect and temporary pigmentation of gingiva by photosensitizer. Several precautions should be made while using PDT such as adequate eye protection, irrigation, and isolation. Conclusion: Combination of mecahnical debridement and PDT is proven effective to increase clinical parameters and decrease bacterial burden in peridontitis treatment.