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Published in: Clinical Oral Investigations 6/2010

01-12-2010 | Original Article

Photodynamic therapy of persistent pockets in maintenance patients—a clinical study

Authors: Andreas Rühling, Jutta Fanghänel, Mohammad Houshmand, Alexander Kuhr, Peter Meisel, Christian Schwahn, Thomas Kocher

Published in: Clinical Oral Investigations | Issue 6/2010

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Abstract

The aim of this study was to compare the short-term performance of a session of single photodynamic therapy (PDT) and of a conventional ultrasonic debridement (UST) in persistent pockets of maintenance patients. In a prospective, randomized, controlled, single-blind clinical study, patients with chronic periodontitis with at least two persistent pockets (>4 mm) were enrolled. They were treated either with UST (n = 29) or PDT (n = 25). Clinical and microbiological examinations were performed at baseline and after 3 month. For UST, the mean probing depth was reduced from 5.3 to 4.5 mm (p = <0.001) and for PDT from 5.3 to 4.7 mm (p < 0.001) with no difference between the two treatment modalities. Microbial counts were significantly reduced about 30% to 40% immediately after debridement but returned to baseline values at month 3 irrespective of treatment. PDT is not superior to conventional mechanical treatment of persistent pockets, but it may be a meaningful therapeutic alternative; the clinical effects were too minor to draw a definitive conclusion.
Literature
1.
go back to reference Adair G (1984) The Hawthorne effect: a reconsideration of the methodological artifact. J Appl Psychol 69:334–345CrossRef Adair G (1984) The Hawthorne effect: a reconsideration of the methodological artifact. J Appl Psychol 69:334–345CrossRef
2.
go back to reference Bardet P, Suvan J, Lang N (1999) Clinical effects of root instrumentation using conventional steel or non-tooth substance removing plastic curettes during supportive periodontal therapy (SPT). J Clin Periodontol 26:742–747CrossRefPubMed Bardet P, Suvan J, Lang N (1999) Clinical effects of root instrumentation using conventional steel or non-tooth substance removing plastic curettes during supportive periodontal therapy (SPT). J Clin Periodontol 26:742–747CrossRefPubMed
3.
go back to reference Bertoloni G, Rossi F, Valduga G, Jori G, Ali H, van Lier JE (1992) Photosensitizing activity of water- and lipid-soluble phthalocyanines on prokaryotic and eukaryotic microbial cells. Microbios 71:33–46PubMed Bertoloni G, Rossi F, Valduga G, Jori G, Ali H, van Lier JE (1992) Photosensitizing activity of water- and lipid-soluble phthalocyanines on prokaryotic and eukaryotic microbial cells. Microbios 71:33–46PubMed
4.
go back to reference Bhatti M, Mac Robert A, Henderson B, Wilson M (2002) Exposure of Porphyromonas gingivalis to red light in the presence of the light-activated antimicrobial agent toluidine blue decreases membrane fluidity. Curr Microbiol 45:118–122CrossRefPubMed Bhatti M, Mac Robert A, Henderson B, Wilson M (2002) Exposure of Porphyromonas gingivalis to red light in the presence of the light-activated antimicrobial agent toluidine blue decreases membrane fluidity. Curr Microbiol 45:118–122CrossRefPubMed
5.
go back to reference Bogren A, Teles RP, Torresyap G, Haffajee AD, Socransky SS, Wennström JL (2008) Locally delivered doxycycline during supportive periodontal therapy: a 3-year study. J Periodontol 79:827–835CrossRefPubMed Bogren A, Teles RP, Torresyap G, Haffajee AD, Socransky SS, Wennström JL (2008) Locally delivered doxycycline during supportive periodontal therapy: a 3-year study. J Periodontol 79:827–835CrossRefPubMed
6.
go back to reference Boutaga K, van Winkelhoff AJ, Vandenbroucke-Grauls CM, Savelkoul PH (2006) The additional value of real-time PCR in the quantitative detection of periodontal pathogens. J Clin Periodontol 33:427–433CrossRefPubMed Boutaga K, van Winkelhoff AJ, Vandenbroucke-Grauls CM, Savelkoul PH (2006) The additional value of real-time PCR in the quantitative detection of periodontal pathogens. J Clin Periodontol 33:427–433CrossRefPubMed
7.
go back to reference Chondros P, Nikolidakis D, Christodoulides N, Rössler R, Gutknecht N, Sculean A (2009) Photodynamic therapy as adjunct to non-surgical periodontal treatment in patients on periodontal maintenance: a randomized controlled clinical trial. Lasers Med Sci 24:681–688CrossRefPubMed Chondros P, Nikolidakis D, Christodoulides N, Rössler R, Gutknecht N, Sculean A (2009) Photodynamic therapy as adjunct to non-surgical periodontal treatment in patients on periodontal maintenance: a randomized controlled clinical trial. Lasers Med Sci 24:681–688CrossRefPubMed
8.
go back to reference Cugini M, Haffajee AD, Smith C, Kent RL Jr, Socransky SS (2000) The effect of scaling and root planing on the clinical and microbiological parameters of periodontal diseases: 12-month results. J Clin Periodontol 27:30–36CrossRefPubMed Cugini M, Haffajee AD, Smith C, Kent RL Jr, Socransky SS (2000) The effect of scaling and root planing on the clinical and microbiological parameters of periodontal diseases: 12-month results. J Clin Periodontol 27:30–36CrossRefPubMed
9.
go back to reference de Almeida JM, Theodoro LH, Bosco AF, Mj N, Oshiiwa M, Garcia VG (2008) In vivo effect of photodynamic therapy on periodontal bone loss in dental furcations. J Periodontol 79:1081–1088CrossRefPubMed de Almeida JM, Theodoro LH, Bosco AF, Mj N, Oshiiwa M, Garcia VG (2008) In vivo effect of photodynamic therapy on periodontal bone loss in dental furcations. J Periodontol 79:1081–1088CrossRefPubMed
10.
go back to reference De Oliveira RR, Schwartz-Filho HO, Novaes AB Jr, Taba M Jr (2007) Antimicrobial photodynamic therapy in the non-surgical treatment of aggressive periodontitis: a preliminary randomized controlled clinical study. J Periodontol 78:965–973CrossRefPubMed De Oliveira RR, Schwartz-Filho HO, Novaes AB Jr, Taba M Jr (2007) Antimicrobial photodynamic therapy in the non-surgical treatment of aggressive periodontitis: a preliminary randomized controlled clinical study. J Periodontol 78:965–973CrossRefPubMed
11.
go back to reference Dobson J, Wilson M (1992) Sensitization of oral bacteria in biofilms to killing by light from a low-power laser. Arch Oral Biol 37:883–887CrossRefPubMed Dobson J, Wilson M (1992) Sensitization of oral bacteria in biofilms to killing by light from a low-power laser. Arch Oral Biol 37:883–887CrossRefPubMed
12.
go back to reference Dörtbudak O, Haas R, Bernhart T, Mailath-Pokorny G (2001) Lethal photosensitization for decontamination of implant surfaces in the treatment of peri-implantitis. Clin Oral Implants Res 12:104–108CrossRefPubMed Dörtbudak O, Haas R, Bernhart T, Mailath-Pokorny G (2001) Lethal photosensitization for decontamination of implant surfaces in the treatment of peri-implantitis. Clin Oral Implants Res 12:104–108CrossRefPubMed
13.
go back to reference Dragoo MR (1992) Clinical evaluation of hand and ultrasonic instruments on subgingival debridement with unmodified and modified ultrasonic inserts. Int J Periodontics Restor Dent 12:310–323 Dragoo MR (1992) Clinical evaluation of hand and ultrasonic instruments on subgingival debridement with unmodified and modified ultrasonic inserts. Int J Periodontics Restor Dent 12:310–323
14.
go back to reference Eickholz P, Kim TS, Schacher B, Reitmeir P, Burklin T, Ratka-Krüger P (2005) Subgingival topical doxycycline versus mechanical debridement for supportive periodontal therapy: a single blind randomized controlled two-center study. Am J Dent 18:341–346PubMed Eickholz P, Kim TS, Schacher B, Reitmeir P, Burklin T, Ratka-Krüger P (2005) Subgingival topical doxycycline versus mechanical debridement for supportive periodontal therapy: a single blind randomized controlled two-center study. Am J Dent 18:341–346PubMed
15.
go back to reference Greenstein G (2005) Position paper: the role of supra- and subgingival irrigation in the treatment of periodontal diseases. J Periodontol 76:2015–2027CrossRefPubMed Greenstein G (2005) Position paper: the role of supra- and subgingival irrigation in the treatment of periodontal diseases. J Periodontol 76:2015–2027CrossRefPubMed
16.
go back to reference Henderson BW (1992) Historical perspective. In: Henderson WH, Dougherty TJ (eds) Photodynaymic therapy. Basic principles and clinical applications. Marcel Dekker, New York, pp 1–15 Henderson BW (1992) Historical perspective. In: Henderson WH, Dougherty TJ (eds) Photodynaymic therapy. Basic principles and clinical applications. Marcel Dekker, New York, pp 1–15
17.
go back to reference Jervøe-Storm PM, Koltzscher M, Falk W, Dörfler A, Jepsen S (2005) Comparison of culture and real-time PCR for detection and quantification of five putative periodontopathogenic bacteria in subgingival plaque samples. J Clin Periodontol 32:778–783CrossRefPubMed Jervøe-Storm PM, Koltzscher M, Falk W, Dörfler A, Jepsen S (2005) Comparison of culture and real-time PCR for detection and quantification of five putative periodontopathogenic bacteria in subgingival plaque samples. J Clin Periodontol 32:778–783CrossRefPubMed
18.
go back to reference Kocher T, Fanghänel J, Schwahn C, Rühling A (2005) A new ultrasonic device in maintenance therapy: perception of pain and clinical efficacy. J Clin Periodontol 32:425–429CrossRefPubMed Kocher T, Fanghänel J, Schwahn C, Rühling A (2005) A new ultrasonic device in maintenance therapy: perception of pain and clinical efficacy. J Clin Periodontol 32:425–429CrossRefPubMed
19.
go back to reference Kömerik N, Wilson M, Poole S (2000) The effect of photodynamic action on two virulence factors of gram-negative bacteria. Photochem Photobiol 72:676–680CrossRefPubMed Kömerik N, Wilson M, Poole S (2000) The effect of photodynamic action on two virulence factors of gram-negative bacteria. Photochem Photobiol 72:676–680CrossRefPubMed
20.
go back to reference Kömerik N, Curnow A, Mac Robert AJ, Hopper C, Speight PM, Wilson M (2002) Fluorescence biodistribution and photosensitising activity of toluidine blue o on rat buccal mucosa. Lasers Med Sci 17:86–92CrossRefPubMed Kömerik N, Curnow A, Mac Robert AJ, Hopper C, Speight PM, Wilson M (2002) Fluorescence biodistribution and photosensitising activity of toluidine blue o on rat buccal mucosa. Lasers Med Sci 17:86–92CrossRefPubMed
21.
go back to reference Malik Z, Hanania J, Nitzan Y (1990) Bactericidal effects of photoactivated porphyrins—an alternative approach to antimicrobial drugs. J Photochem Photobiol B 5:281–293CrossRefPubMed Malik Z, Hanania J, Nitzan Y (1990) Bactericidal effects of photoactivated porphyrins—an alternative approach to antimicrobial drugs. J Photochem Photobiol B 5:281–293CrossRefPubMed
22.
go back to reference Malik Z, Ladan H, Nitzan Y, Ehrenberg B (1990) The bactericidal activity of a deuteroporphyrin-hemin mixture on gram-positive bacteria. A microbiological and spectroscopic study. J Photochem Photobiol B 6:419–430CrossRefPubMed Malik Z, Ladan H, Nitzan Y, Ehrenberg B (1990) The bactericidal activity of a deuteroporphyrin-hemin mixture on gram-positive bacteria. A microbiological and spectroscopic study. J Photochem Photobiol B 6:419–430CrossRefPubMed
23.
go back to reference McColl E, Patel K, Dahlen G, Tonetti M, Graziani F, Suvan J, Laurell L (2006) Supportive periodontal therapy using mechanical instrumentation or 2% minocycline gel: a 12-month randomized, controlled, single masked pilot study. J Clin Periodontol 33:141–150CrossRefPubMed McColl E, Patel K, Dahlen G, Tonetti M, Graziani F, Suvan J, Laurell L (2006) Supportive periodontal therapy using mechanical instrumentation or 2% minocycline gel: a 12-month randomized, controlled, single masked pilot study. J Clin Periodontol 33:141–150CrossRefPubMed
24.
go back to reference Meisel P, Kocher T (2005) Photodynamic therapy for periodontal diseases: state of the art. J Photochem Photobiol B 79:159–170CrossRefPubMed Meisel P, Kocher T (2005) Photodynamic therapy for periodontal diseases: state of the art. J Photochem Photobiol B 79:159–170CrossRefPubMed
25.
go back to reference Müller P, Guggenheim B, Schmidlin PR (2007) Efficacy of gasiform ozone and photodynamic therapy on a multispecies oral biofilm in vitro. Eur J Oral Sci 115:77–80CrossRefPubMed Müller P, Guggenheim B, Schmidlin PR (2007) Efficacy of gasiform ozone and photodynamic therapy on a multispecies oral biofilm in vitro. Eur J Oral Sci 115:77–80CrossRefPubMed
26.
go back to reference Nosal G, Scheidt MJ, O’Neal R, van Dyke TE (1991) The penetration of lavage solution into the periodontal pocket during ultrasonic instrumentation. J Periodontol 62:554–557PubMed Nosal G, Scheidt MJ, O’Neal R, van Dyke TE (1991) The penetration of lavage solution into the periodontal pocket during ultrasonic instrumentation. J Periodontol 62:554–557PubMed
27.
go back to reference Petersilka GJ, Tunkel J, Barakos K, Heinecke A, Häberlein I, Flemmig TF (2003) Subgingival plaque removal at interdental sites using a low-abrasive air polishing powder. J Periodontol 74:307–311CrossRefPubMed Petersilka GJ, Tunkel J, Barakos K, Heinecke A, Häberlein I, Flemmig TF (2003) Subgingival plaque removal at interdental sites using a low-abrasive air polishing powder. J Periodontol 74:307–311CrossRefPubMed
28.
go back to reference Petersilka GJ, Draenert M, Mehl A, Hickel R, Flemmig TF (2003) Safety and efficiency of novel sonic scaler tips in vitro. J Clin Periodontol 30:551–555CrossRefPubMed Petersilka GJ, Draenert M, Mehl A, Hickel R, Flemmig TF (2003) Safety and efficiency of novel sonic scaler tips in vitro. J Clin Periodontol 30:551–555CrossRefPubMed
29.
go back to reference Pfitzner A, Sigusch BW, Albrecht V, Glockmann E (2004) Killing of periodontopathogenic bacteria by photodynamic therapy. J Periodontol 75:1343–1349CrossRefPubMed Pfitzner A, Sigusch BW, Albrecht V, Glockmann E (2004) Killing of periodontopathogenic bacteria by photodynamic therapy. J Periodontol 75:1343–1349CrossRefPubMed
30.
go back to reference Rabbani GM, Ash MM Jr, Caffesse RG (1981) The effectiveness of subgingival scaling and root planning in calculus removal. J Periodontol 52:119–123CrossRefPubMed Rabbani GM, Ash MM Jr, Caffesse RG (1981) The effectiveness of subgingival scaling and root planning in calculus removal. J Periodontol 52:119–123CrossRefPubMed
31.
go back to reference Rhemrev GE, Timmerman MF, Veldkamp I, van Winkelhoff AJ, van der Velden U (2006) Immediate effect of instrumentation on the subgingival microflora in deep inflamed pockets under strict plaque control. J Clin Periodontol 33:42–48CrossRefPubMed Rhemrev GE, Timmerman MF, Veldkamp I, van Winkelhoff AJ, van der Velden U (2006) Immediate effect of instrumentation on the subgingival microflora in deep inflamed pockets under strict plaque control. J Clin Periodontol 33:42–48CrossRefPubMed
32.
go back to reference Sharkey SM, Wilson BC, Moorehead R, Singh G (1993) Mitochondrial alterations in photodynamic therapy-resistant cells. Cancer Res 52:4994–4999 Sharkey SM, Wilson BC, Moorehead R, Singh G (1993) Mitochondrial alterations in photodynamic therapy-resistant cells. Cancer Res 52:4994–4999
33.
go back to reference Sigusch BW, Pfitzner A, Albrecht V, Glockmann E (2005) Efficacy of photodynamic therapy on inflammatory signs and two selected periodontopathogenic species in a beagle dog model. J Periodontol 76:1100–1105CrossRefPubMed Sigusch BW, Pfitzner A, Albrecht V, Glockmann E (2005) Efficacy of photodynamic therapy on inflammatory signs and two selected periodontopathogenic species in a beagle dog model. J Periodontol 76:1100–1105CrossRefPubMed
34.
go back to reference Socransky SS, Haffajee AD, Smith C, Martin L, Haffajee JA, Uzel NG, Goodson JM (2004) Use of checkerboard DNA-DNA hybridization to study complex microbial ecosystems. Oral Microbiol Immunol 19:352–362CrossRefPubMed Socransky SS, Haffajee AD, Smith C, Martin L, Haffajee JA, Uzel NG, Goodson JM (2004) Use of checkerboard DNA-DNA hybridization to study complex microbial ecosystems. Oral Microbiol Immunol 19:352–362CrossRefPubMed
35.
go back to reference Soukos NS, Ximenez-Fyvie LA, Hamblin MR, Socransky SS, Hasan T (1998) Targeted antimicrobial photochemotherapy. Antimicrob Agents Chemother 42:2595–2601PubMed Soukos NS, Ximenez-Fyvie LA, Hamblin MR, Socransky SS, Hasan T (1998) Targeted antimicrobial photochemotherapy. Antimicrob Agents Chemother 42:2595–2601PubMed
36.
go back to reference Soukos NS, Socransky SS, Mullholland SE, Lee S, Doukas AG (2000) Photomechanical drug delivery into bacterial biofilms. Pharm Res 17:405–409CrossRefPubMed Soukos NS, Socransky SS, Mullholland SE, Lee S, Doukas AG (2000) Photomechanical drug delivery into bacterial biofilms. Pharm Res 17:405–409CrossRefPubMed
37.
go back to reference Soukos NS, Mulholland SE, Socransky SS, Doukas AG (2003) Photodestruction of human dental plaque bacteria: enhancement of the photodynamic effect by photomechanical waves in an oral biofilm model. Lasers Surg Mes 33:161–168CrossRef Soukos NS, Mulholland SE, Socransky SS, Doukas AG (2003) Photodestruction of human dental plaque bacteria: enhancement of the photodynamic effect by photomechanical waves in an oral biofilm model. Lasers Surg Mes 33:161–168CrossRef
38.
go back to reference Stambaugh RV, Dragoo M, Smith DM, Carasali L (1981) The limits of subgingival scaling. Int J Periodontic Restor 1:30–41 Stambaugh RV, Dragoo M, Smith DM, Carasali L (1981) The limits of subgingival scaling. Int J Periodontic Restor 1:30–41
39.
go back to reference Stojiljkovic I, Evavold BD, Kumar V (2001) Antimicrobial properties of porphyrins. Expert Opin Investig Drugs 10:309–320CrossRefPubMed Stojiljkovic I, Evavold BD, Kumar V (2001) Antimicrobial properties of porphyrins. Expert Opin Investig Drugs 10:309–320CrossRefPubMed
40.
go back to reference Tomasi C, Schander K, Dahlen G, Wennström JL (2006) Short-term clinical and microbiologic effects of pocket debridement with an Er:YAG laser during periodontal maintenance. J Periodontol 77:111–118CrossRefPubMed Tomasi C, Schander K, Dahlen G, Wennström JL (2006) Short-term clinical and microbiologic effects of pocket debridement with an Er:YAG laser during periodontal maintenance. J Periodontol 77:111–118CrossRefPubMed
41.
go back to reference Williams JA, Pearson GJ, Colles MJ (2006) Antibacterial action of photoactivated disinfection PAD used on endodontic bacteria in planktonic suspension and in artificial and human root canals. J Dentistry 34:363–371CrossRef Williams JA, Pearson GJ, Colles MJ (2006) Antibacterial action of photoactivated disinfection PAD used on endodontic bacteria in planktonic suspension and in artificial and human root canals. J Dentistry 34:363–371CrossRef
42.
go back to reference Wilson M, Dobson J, Harvey W (1992) Sensitization of oral bacteria to killing by low-power laser radiation. Curr Microbiol 25:77–81CrossRefPubMed Wilson M, Dobson J, Harvey W (1992) Sensitization of oral bacteria to killing by low-power laser radiation. Curr Microbiol 25:77–81CrossRefPubMed
43.
go back to reference Wilson M, Pratten J (1995) Lethal photosensitisation of Staphylococcus aureus in vitro: effect of growth phase, serum, and pre-irradiation time. Lasers Surg Med 16:272–276CrossRefPubMed Wilson M, Pratten J (1995) Lethal photosensitisation of Staphylococcus aureus in vitro: effect of growth phase, serum, and pre-irradiation time. Lasers Surg Med 16:272–276CrossRefPubMed
44.
go back to reference Wong MY, Lu CL, Liu CM, Hou L (1999) Microbiological response of localized sites with recurrent periodontitis in maintenance patients treated with tetracycline fibers. J Periodontol 70:861–868CrossRefPubMed Wong MY, Lu CL, Liu CM, Hou L (1999) Microbiological response of localized sites with recurrent periodontitis in maintenance patients treated with tetracycline fibers. J Periodontol 70:861–868CrossRefPubMed
45.
go back to reference Yilmaz S, Kuru B, Kuru L, Noyan U, Argun D, Kadir T (2002) Effect of gallium arsenide diode laser on human periodontal disease: a microbiological and clinical study. Lasers Surg Med 30:60–66CrossRefPubMed Yilmaz S, Kuru B, Kuru L, Noyan U, Argun D, Kadir T (2002) Effect of gallium arsenide diode laser on human periodontal disease: a microbiological and clinical study. Lasers Surg Med 30:60–66CrossRefPubMed
Metadata
Title
Photodynamic therapy of persistent pockets in maintenance patients—a clinical study
Authors
Andreas Rühling
Jutta Fanghänel
Mohammad Houshmand
Alexander Kuhr
Peter Meisel
Christian Schwahn
Thomas Kocher
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
Clinical Oral Investigations / Issue 6/2010
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-009-0347-4

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