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01-08-2019 | Original Article

Antimicrobial photodynamic therapy as adjunct to non-surgical periodontal treatment in smokers: a randomized clinical trial

Authors: Mariana Sales de Melo Soares, Cristine D’Almeida Borges, Marcos de Mendonça Invernici, Fabiani Gai Frantz, Luciene Cristina de Figueiredo, Sérgio Luis Scombatti de Souza, Mario Taba Jr., Michel Reis Messora, Arthur Belém Novaes Jr

Published in: Clinical Oral Investigations | Issue 8/2019

Abstract

Objectives

This study aims to investigate the additional influence of multiple applications of antimicrobial photodynamic therapy (aPDT) in smokers with chronic periodontitis.

Materials and methods

Twenty smokers with chronic periodontitis were treated in a split-mouth design study with aPDT adjunct to Scaling and Root Planing (SRP) or SRP. aPDT was performed by using a laser light source with 660 nm wavelength associated with a photosensitizer. The applications were performed in four episodes (at days 0, 2, 7, and 14). All patients were monitored for 90 days. Plaque index, probing depth, clinical attachment level, and bleeding on probing were performed at baseline, 30, and 90 days after the SRP. Gingival crevicular fluid and subgingival plaque samples were collected for immunological and microbiological analysis, respectively. Data obtained were statistically analyzed.

Results

aPDT as an adjunct to SRP did not demonstrate statistically significant advantages on clinical parameters when compared with SRP alone. No statistic significant differences between groups were observed (p < 0.05). Levels of anti-inflammatory cytokines and bacterial species were comparable in both groups at day 90 after treatment.

Conclusion

Periodontal treatment with SRP + aPDT in multiples episodes was not able to promote additional clinical, immunological, and microbiological benefits in smokers when compared SRP alone in patients with chronic periodontitis.

Clinical relevance

Multiple episodes of aPDT adjunctive to non-surgical treatment did not improve significantly the clinical, immunological, and microbiological parameters when compared with SRP alone. More randomized clinical trials are needed to evaluate adjuvant therapies for scaling and root planning in smokers with chronic periodontitis. ClinicalTrials.gov Identifier: NCT03039244

Phenothiazine chloride, 10 mg/Ml, HELBO Blue, HELBO Photodynamic Systems, Grieskirchen, Austria

Minilaser 2075F, Helbo Photodynamic Systems

HELBO 3D Pocket Probe, HELBO Photodynamic Systems

Florida Probe, Gainesville, FL

PerioPapers, Interstate Drug Exchange, Amityville, NY

MilliplexMap, Merck Millipore, Billerica, MA

MAGPIX analyzer, Luminex, Austin, TX

Salimetrics Inc., State College, PA, USA

Genco RJ, Borgnakke WS (2013) Risk factors for periodontal disease. Periodontol 62:59–94. https://doi.org/10.1111/j.1600-0757.2012.00457. CrossRef

Zeng J, Williams SM, Fletcher DJ, Cameron CM, Broadbent JM, Shearer DM, Thomson WM (2014) Re-examining the association between smoking and periodontitis in the Dunedin study with an enhanced analytical approach. J Periodontol 85:1390–1397. https://doi.org/10.1902/jop.2014.130577. CrossRefPubMed

Johnson GK, Hill M (2004) Cigarette smoking and the periodontal patient. J Periodontol 75:196–209. https://doi.org/10.1902/jop.2004.75.2.196 CrossRefPubMed

Ryder MI (2007) The influence of smoking on host responses in periodontal infections. Periodontol 43:267–277. https://doi.org/10.1111/j.1600-0757.2006.00163.x CrossRef

van der Velden U, Varoufaki A, Hutter JW, Xu L, Timmerman MF, van Winkelhoff AJ, Loos BG (2003) Effect of smoking and periodontal treatment on the subgingival microflora. J Clin Periodontol 30:603–610CrossRefPubMed

Feres M, Bernal M, Matarazzo F, Faveri M, Duarte PM, Figueiredo LC (2015) Subgingival bacterial recolonization after scaling and root planning in smokers with chronic periodontitis. Aust Dent J 60:225–232. https://doi.org/10.1111/adj.12225 CrossRefPubMed

Carvalho LH, D’Avila GB, Leao A, Gonçalves C, Haffajee AD, Socransky SS, Feres M (2005) Scaling and root planning, systemic metronidazole and professional plaque removal in the treatment of chronic periodontitis in a Brazilian population II. Microbiological results. J Clin Periodontol 32:406–411. https://doi.org/10.1111/j.1600-051X.2005.00720. CrossRefPubMed

Herrera D, Sanz M, Jepsen S, Needleman I, Roldan SA (2002) Systematic review on the effect of systemic antimicrobials as an adjunct to scaling and root planning in periodontitis patients. J Clin Periodontol 29:136–159CrossRefPubMed

Haffajee AD, Socransky SS, Gunsolley JC (2003) Systemic anti-infective periodontal therapy: a systematic review. Ann Periodontol 8:115–181. https://doi.org/10.1902/annals.2003.8.1.115 CrossRefPubMed

10.

Matarazzo F, Figueiredo LC, Cruz SE, Faveri M, Feres M (2008) Clinical and microbiological benefits of systemic metronidazole and amoxicillin in the treatment of smokers with chronic periodontitis: a randomized placebo-controlled study. J Clin Periodontol 35:885–896. https://doi.org/10.1111/j.1600-051X.2008.01304. CrossRefPubMed

11.

Pallasch TJ (2003) Antibiotic resistance. Dent Clin N Am 47:623–639CrossRefPubMed

12.

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 78:965–973. https://doi.org/10.1902/jop.2007.060494 CrossRefPubMed

13.

Novaes AB Jr, Schwartz-Filho HO, de Oliveira RR, Feres M, Sato S, Figueiredo LC (2012) Antimicrobial photodynamic therapy in the non-surgical treatment of aggressive periodontitis: microbiological profile. Lasers Med Sci 27:389–395. https://doi.org/10.1007/s10103-011-0901-6 CrossRefPubMed

14.

Queiroz AC, Suaid FA, de Andrade PF, Oliveira FS, Novaes AB Jr, Taba M Jr, Palioto DB, Grisi MF, Souza SL (2015) Adjunctive effect of antimicrobial photodynamic therapy to nonsurgical periodontal treatment in smokers: a randomized clinical trial. Lasers Med Sci 30:617–625. https://doi.org/10.1007/s10103-013-1379-1 CrossRefPubMed

15.

Meisel P, Kocher T (2005) Photodynamic therapy for periodontal diseases: state of the art. J Photochem Photobiol B 79:159–170. https://doi.org/10.1016/j.jphotobiol.2004.11.023 CrossRefPubMed

16.

Braun A, Dehn C, Krause F, Jepsen S (2008) Short-term clinical effects of adjunctive antimicrobial photodynamic therapy in periodontal treatment: a randomized clinical trial. J Clin Periodontol 35:877–884CrossRefPubMed

17.

Betsy CS, Prasanth KV, Baiju J, Prasanthila N, Subhash (2014) Efficacy ofantimicrobial photodynamic therapy in the management of chronicperiodontitis: a randomized controlled clinical trial. J Clin Periodontol 41:573–581CrossRefPubMed

18.

de Oliveira RR, Schwartz-Filho HO, Novaes AB Jr, Garlet GP, de Souza RF, Taba M Jr, Scombatti SLS, Ribeiro FJ (2009) Antimicrobial photodynamic therapy in the non-surgical treatment of aggressive periodontitis: cytokine profile in gingival crevicular fluid, preliminary results. J Periodontol 80:98–105. https://doi.org/10.1902/jop.2009.070465 CrossRefPubMed

19.

Balata ML, de Andrade LP, Santos DB, Cavalcanti AN, Tunes Uda R, Ribeiro EP, Bittencourt S (2013) Photodynamic therapy associated with full-mouth ultrasonic debridement in the treatment of severe chronic periodontitis: a randomized controlled clinical trial. J Appl Oral Sci 21:208–214. https://doi.org/10.1590/1678-7757201302366 CrossRefPubMedPubMedCentral

20.

Petelin M, Perkic K, Seme K, Gašpirc B (2014) Effect of repeated adjunctive antimicrobial photodynamic therapy on subgingival periodontal pathogens in the treatment of chronic periodontitis. Lasers Med Sci 30:1647–1656. https://doi.org/10.1007/s10103-014-1632-2 CrossRefPubMed

21.

Moreira AL, Novaes AB Jr, Grisi MF, Taba M Jr, Souza SL, Palioto DB, de Oliveira PG, Casati MZ, Casarin RC, Messora MR (2015) Antimicrobial photodynamic therapy as an adjunct to non-surgical treatment of aggressive periodontitis: a split-mouth randomized controlled trial. J Periodontol 86:376–386. https://doi.org/10.1902/jop.2014.140392 CrossRefPubMed

22.

Dilsiz A, Canakci V, Aydin T (2013) Clinical effects of potassium-titanyl-phosphate laser and photodynamic therapy on outcomes of treatment of chronic periodontitis: a randomized controlled clinical trial. J Periodontol 84:278–286. https://doi.org/10.1902/jop.2012.120096 CrossRefPubMed

23.

Armitage GC (1999) Development of a classification system for periodontal diseases and conditions. Ann Periodontol 4:1–6. https://doi.org/10.1902/annals.1999.4.1.1. CrossRefPubMed

24.

O'Leary TJ, Drake RB, Naylor JE (1972) The plaque control record. J Periodontol 43:38. https://doi.org/10.1902/jop.1972.43.1.38 CrossRefPubMed

25.

Ainamo J, Bay I (1976) Periodontal indexes for and in practice. Tandlaegebladet 80:149–152PubMed

26.

Tirachaimongkol C, Pothacharoen P, Reichart PA, Khongkhunthian P (2016) Relation between the stability of dental implants and two biological markers during the healing period: a prospective clinical study. Int J Implant Dent 2(1):27CrossRefPubMedPubMedCentral

27.

Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL Jr (1998) Microbial complexes in subgingival plaque. J Clin Periodontol 25:134–144CrossRefPubMed

28.

Socransky SS, Haffajee AD, Smith C, Dibart S (1991) Relation of counts of microbial species to clinical status at the sampled site. J Clin Periodontol 8:766–775CrossRef

29.

Al-Zahrani MS, Austah ON (2011) Photodynamic therapy as an adjunctive to scaling and root planing in treatment of chronic periodontitis in smokers. Saudi Med J 32:1183–1188PubMed

30.

Lesaffre E, Philstrom B, Needleman I, Worthington H (2009) The design and analysis of split-mouth studies: what statisticians and clinicians should know. Stat Med 28(28):3470–3482CrossRefPubMed

31.

Quirynen M, De Soete M, Dierickx K, van Steenberghe D (2001) The intra-oral translocation of periodontopathogens jeopardises the outcome of periodontal therapy. A review of the literature. J Clin Periodontol 28(6):499–507CrossRefPubMed

32.

Street CN, Pedigo LA, Loebel NG (2010) Energy dose parameters affect antimicrobial photodynamic therapy-mediated eradication of periopathogenic biofilm and planktonic cultures. Photomed Laser Surg 28:S61–S66. https://doi.org/10.1089/pho.2009.2622. CrossRefPubMed

33.

Akram Z, Abduljabbar T, Sauro S, Daood U (2016) Effect of photodynamic therapy and laser alone as adjunct to scaling and root planing on gingival crevicular fluid inflammatory proteins in periodontal disease: a systematic review. Photodiagn Photodyn Ther 16:142–153. https://doi.org/10.1016/j.pdpdt.2016.09.004 CrossRef

34.

Matuliene G, Studer R, Lang NP, Schmidlin K, Pjetursson BE, Salvi GE, Brägger U, Zwahlen M (2010) Significance of periodontal risk assessment in the recurrence of periodontitis and tooth loss. J Clin Periodontol 37:191–199. https://doi.org/10.1111/j.1600-051X.2009.01508.x CrossRefPubMed

35.

Matuliene G, Pjetursson BE, Salvi GE, Schmidlin K, Brägger U, Zwahlen M, Lang NP (2008) Influence of residual pockets on progression of periodontitis and tooth loss: results after 11 years of maintenance. J Clin Periodontol 35:685–695. https://doi.org/10.1111/j.1600-051X.2008.01245.x CrossRefPubMed

36.

Xue D, Tang L, Bai Y, Ding Q, Wang P, Zhao Y (2017) Clinical efficacy of photodynamic therapy adjunctive to scaling and root planning in the treatment of chronic periodontitis: a systematic review and meta-analysis. Photodiagn Photodyn Ther 18:119–127. https://doi.org/10.1016/j.pdpdt.2017.01.183 CrossRef

37.

Ramos UD, Ayub LG, Reino DM, Grisi MF, Taba M Jr, Souza SL, Palioto DB, Novaes AB Jr (2016) Antimicrobial photodynamic therapy as an alternative to systemic antibiotics: results from a double-blind, randomized, placebo-controlled, clinical study on type 2 diabetics. J Clin Periodontol 43:147–155. https://doi.org/10.1111/jcpe.12498 CrossRefPubMed

38.

Haffajee AD, Socransky SS (2001) Relationship of cigarette smoking to the subgingival microbiota. J Clin Periodontol 28:377–388CrossRefPubMed

39.

Kumar PS (2012) Smoking and the subgingival ecosystem: a pathogen-enriched community. Future Microbiol 7:917–919. https://doi.org/10.2217/fmb.12.71 CrossRefPubMed

40.

Boström L, Linder LE, Bergström J (1998) Clinical expression of TNF-alpha in smoking-associated periodontal disease. J Clin Periodontol 25:767–777CrossRefPubMed

41.

Akpinar A, Toker H, Ozdemir H, Bostanci V, Aydin H (2013) The effects of non-surgical periodontal therapy on oxidant and anti-oxidant status in smokers with chronic periodontitis. Arch Oral Biol 58:717–723. https://doi.org/10.1016/j.archoralbio.2012.11.009 CrossRefPubMed

42.

Queiroz AC, Suaid FA, de Andrade PF, Novaes AB Jr, Taba M Jr, Palioto DB, Grisi MF, Souza SL (2014) Antimicrobial photodynamic therapy associated to nonsurgical periodontal treatment in smokers: microbiological results. J Photochem Photobiol B 141:170–175. https://doi.org/10.1016/j.jphotobiol.2014.10.017 CrossRefPubMed

43.

Lee J, Taneja V, Vassallo R (2012) Cigarette smoking and inflammation: cellular and molecular mechanisms. J Dent Res 91:142–149. https://doi.org/10.1177/0022034511421200 CrossRefPubMedPubMedCentral

44.

Nociti FH Jr, Casati MZ, Duarte PM (2015) Current perspective of the impact of smoking on the progression and treatment of periodontitis. Periodontol 67:187–210. https://doi.org/10.1111/prd.12063 CrossRef

45.

Johannsen A, Susin C, Gustafsson A (2014) Smoking and inflammation: evidence for a synergistic role in chronic disease. Periodontol 64:111–126. https://doi.org/10.1111/j.1600-0757.2012.00456.x CrossRef

46.

Rawlinson A, Grummitt JM, Walsh TF, Ian Douglas CW (2003) Interleukin 1 and receptor antagonist levels in gingival crevicular fluid in heavy smokers versus non-smokers. J Clin Periodontol 30:42–48CrossRefPubMed

47.

Tymkiw KD, Thunell DH, Johnson GK, Joly S, Burnell KK, Cavanaugh JE, Brogden KA, Guthmiller JM (2011) Influence of smoking on gingival crevicular fluid cytokines in severe chronic periodontitis. J Clin Periodontol 38:219–228. https://doi.org/10.1111/j.1600-051X.2010.01684.x CrossRefPubMed

48.

Giannopoulou C, Kamma JJ, Mombelli A (2003) Effect of inflammation, smoking and stress on gingival crevicular fluid cytokine level. J Clin Periodontol 30:145–153CrossRefPubMed

49.

Assem NZ, Alves MLF, Lopes AB, Gualberto EC Jr, Garcia VG, Theodoro LH (2017) Antibiotic therapy as an adjunct to scaling and root planning in smokers: a systematic review and meta-analysis. Braz Oral Res 3(31):e67. https://doi.org/10.1590/1807-3107BOR-2017.vol31.0067. CrossRef

50.

Faveri M, Rebello A, de Oliveira DR Borges I Jr, Duarte PM, Figueiredo LC, Feres M (2014) Clinical and microbiologic effects of adjunctive metronidazole plus amoxicillin in the treatment of generalized chronic periodontitis: smokers versus non-smokers. J Periodontol 85:581–591. https://doi.org/10.1902/jop.2013.130278 CrossRefPubMed

51.

Chambrone L, Vargas M, Arboleda S, Serna M, Guerrero M, de Sousa J, Lafaurie GI (2016) Efficacy of local and systemic antimicrobials in the non-surgical treatment of smokers with chronic periodontitis: a systematic review. J Periodontol 87:1320–1332. https://doi.org/10.1902/jop.2016.160268 CrossRefPubMed

Title: Antimicrobial photodynamic therapy as adjunct to non-surgical periodontal treatment in smokers: a randomized clinical trial
Authors: Mariana Sales de Melo Soares
Cristine D’Almeida Borges
Marcos de Mendonça Invernici
Fabiani Gai Frantz
Luciene Cristina de Figueiredo
Sérgio Luis Scombatti de Souza
Mario Taba Jr.
Michel Reis Messora
Arthur Belém Novaes Jr
Publication date: 01-08-2019
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 8/2019
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-018-2740-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Antimicrobial photodynamic therapy as adjunct to non-surgical periodontal treatment in smokers: a randomized clinical trial

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

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