Treatment of aggressive periodontitis; treatment of chronic periodontitis
Treatment of aggressive periodontitis with antimicrobial photodynamic therapy or systemic antibiotics. A prospective, randomized clinical study
By N.B. Arweiler(1), P. Małgorzata(2), T.M. Auschill(1), A. Skurska(2), E. Dolińska(2), J. Pietruski(2), A. Sculean(3)
(1)Marburg/Germany, (2)Białystok/Poland, (3)Berne/Switzerland
Aim: To compare clinically the treatment of patients with aggressive peridontitis (AP) by means of full-mouth scaling and root planing (SRP) followed by either additional application of antimicrobial, photodynamic therapy (aPDT) or administration of systemic antibiotics (AB).
Material and Methods: Thirty-six patients with AP and at least 3 sites with pocket depth (PD) 6mm received full mouth subgingival scaling and root planing (SRP) performed within 48 hours at all teeth with PD>4mm. Eighteen subjects received amoxicillin (3x 375 mg/d) + metronidazole (250 mg/d) for 7 days. Eighteen other subjects received treatment with aPDT at the day of SRP and at 7 days after (without SRP). The following parameter were measured at baseline and after 6 months: PD, gingival recession (GR), clinical attachment level (CAL), bleeding on probing and plaque index at test teeth (PD≥4mm; BOP, PI), as well as full mouth plaque index (FMPI) and full mouth BOP (FMBOP). Statistical analysis was performed with IBM SPSS statistics 19 (IBM Company).
Results: After 6 months, PD was significantly reduced in both groups (from 4.98±0.76 to 3.01±0.56 in AB, from 5.05±0.48 to 3.93±0.78 in aPDT), while AB revealed significantly lower values compared to aPDT (p=0.001). GR did not change significantly. CAL was significantly reduced in AB (5.49±1.11 to 3.65±0.88; p<0.001), but not in aPDT (5.82±1.08 to 4.78±1.31; p=0.058); both groups were significantly different (p=0.005).
Conclusion: Both therapies led to statistically significant clinical improvements compared to baseline but the systemic administration of antibiotics resulted in significantly higher reduction of PD and CAL compared to a PDT.
A new biophotonic system as an adjunct to the treatment of chronic periodontitis. Preliminary results By J. Kamma(1), N. Loupis(2), D. Karapetsa(3), S. Vichos(4)(1)Piraeus/Greece, (2)Kifisia/Greece, (3)Paris/France, (4)Voula/Greece
Aim: A novel biophotonic system (gel/light) was applied adjunctively to the treatment of chronic periodontitis using a gel comprising photoactivators of specific absorption to blue-green light (430-530nm) and healing factors. The basis is urea peroxide releasing O2 and free radicals upon breakdown.Material and Methods: Twenty ChP patients (49.3}5.2 years), following baseline measurements for PPD, CAL and BOP, received OHI and supragingival scaling. Thereafter, were randomly assigned to test group that received full mouth SRP plus biophotonic system completed within 24 hours and to control group that received SRP per jaw completed within 48 hours. The biophotonic gel was used during the instrumentation as well as a photoactivators' medium. A 532nm KTP (Quanta System) used in a pulsed mode on=0.10ms/toff=0.10ms at 0.4W was applied into the pockets. Clinical parameters were recorded at 3 and 6 months post-therapy by two calibrated examiners.Results: Both groups showed a significant reduction from BL-3 and 6 months in all clinical parameters. The CAL from 5.32}1.92mm at BL dropped to 4.10}1.69mm 6 months post-therapy, in the test group and from 5.21}1.73mm to 4.92}1.81mm, in the control group. BOP showed significant reduction in both groups from BL-6 months (62.42% test) and (43.54% control), p<0.05 in favor of the test group.Conclusion: Within the limits of this study, the biophotonic system as an adjunct to SRP, apart from the significant reduction in all clinical parameters up to six months post-therapy, showed a better tolerance in the procedure and facilitated mechanical instrumentation. Further well-designed studies are needed to support these preliminary results.
