Antimicrobial Photodynamic Therapy as an Adjunctive Modality in the Treatment of Chronic Periodontitis
INTRODUCTION: Due to penetration of pathogenic bacteria into the periodontal tissues in moderate to severe periodontitis, the mechanical methods are not sufficient in these cases. Therefore, administration of local/systemic antibiotic is recommended following mechanical root debridement. However, side effects of antibiotics such as microbial resistance and patient allergy led to development of alternative methods. One of the suggested methods is the antimicrobial photodynamic therapy (aPDT). aPDT is a local non invasive treatment modality without the side effects caused by antibiotics. The aim of this study was to collect the clinical articles related to the application of aPDT in the treatment of chronic periodontitis.
METHODS: In order to find related clinical articles, a search of PubMed, Google Scholar and Science Direct until 2012 was performed.
RESULTS: A total of 11 articles were found. In 7 of the 11 articles, the assessment of aPDT led to a significant improvement in the clinical attachment and probing depth. In 4 studies, there was no difference between the scaling & root planing (SRP) and adjunctive application of aPDT. aPDT in most cases resulted in less gingival bleeding compare to SRP alone. Furthermore, its application in multiple doses was more effective in comparison to a single dose treatment.
CONCLUSION: It appears that aPDT is effective as an adjunctive therapy compared to conventional non_surgical treatment alone, and is recommended in multiple doses in order to achieve more appropriate results.
Flemmig TF. Periodontitis. Ann Periodontol 1999; 4(1):32–8.
Amano A. Disruption of epithelial barrier and impairment of cellular function by Porphyromonas gingivalis. Front Biosci 2007; 12: 3965–74.
Meyer DH, Sreenivasan PK, Fives-Taylor PM. Evidence for invasion of a human oral cell line by Actinobacillus actinomycetemcomitans. Infect Immun 1991; 59(8): 2719–26.
Dragoo MR. A Clinical evaluation of hand and ultrasonic instruments on subgingival debridement with unmodified and modified ultrasonic inserts. Int J Periodontics Restorative Dent 1992; 12(4): 310–23.
Rabbani GM, Ash MM Jr, Caffesse RG .The effectiveness of subgingival scaling and root planing in calculus removal. J Periodontol 1981; 52(3): 119–23.
Stambaugh RV, Dragoo M, Smith DM, Carasali L. The limits of subgingival scaling. Int J Periodontics Restorative Dent 1981; 1(5): 30–41.
Petersilka GJ, Tunkel J, Barakos K, Heinecke A, Häberlein I, Flemmig TF. Subgingival plaque removal at interdental sites using a low-abrasive air polishing powder. J Periodontol 2003; 74(3): 307–11.
Petersilka GJ, Draenert M, Mehl A, Hickel R, Flemmig TF. Safety and efficiency of novel sonic scaler tips in vitro. J Clin Periodontol 2003; 30(6): 551–5.
Cugini M, Haffajee AD, Smith C, Kent RL Jr, Socransky SS. The effect of scaling and root planing on the clinical and microbiological parameters of periodontal diseases: 12-month results. J Clin Periodontol 2000; 27(1):30–6.
Dr i sko CH. Non-surgical pocket therapy: pharmacotherapeutics. Ann Periodontol 1996; 1(1):491– 566.
Tonetti MS, et Lindhe J. The use of topical antibiotics in periodontal pockets. In: Lang NP, Karring T (eds) Proceedings of the 2nd European Workshop on Periodontology. Quintessence 1997: 78–109.
Socransky SS, Haffajee AD. Dental biofilms: difficult therapeutic targets. Periodontol 2000 2002; 28: 12–55.
Walker CB. The acquisition of antibiotic resistance in the periodontal microflora. Periodontol 2000 1996; 10: 79–88.
Feres M, Haffajee AD, Allard K, Som S, Goodson JM, Socransky SS. Antibiotic resistance of subgingival species during and after antibiotic therapy. J Clin Periodontol 2002; 29(8): 724–35.
Ryder MI. An update on HIV and periodontal disease. J Periodontol 2002; 73(9): 1071-8.
Muller HP, Holderrieth S, Burkhardt U, Hoffler U. In vitro antimicrobial susceptibility of oral strains of Actinobacillus actinomycetemcomitans to seven antibiotics. J Clin Periodontol 2002; 29(8): 736-42.
Raab O. [The effect of fluorescent agents on infusoria] Z Biol 1900; 39: 524–6.German.
Allison RR, Baganto VS, Cuenca R, Downie GH, Sibata CH. The future of photodynamic therapy in oncology. Future Oncol 2006; 2(1):53–71.
Raghavendra M, Koregol A, Bhola S. Photodynamic therapy: a targeted therapy in periodontics. Aust Dent J 2009; 54:(1 Suppl): 102-9.
Ochsner M. Photophysical and photobiological processes in the photodynamic therapy of tumours. J Photochem Photobiol B 1997; 39(1): 1–18.
Moan J, Berg K. The photodegradation of porphyrins in cells that can be used to estimate the lifetime of singlet oxygen. Photochem Photobiol 1991; 53(4): 549–53.
Peng Q, Moan J, Nesland JM. Correlation of subcellular and intratumoral photosensitizer localization with ultrastructural features after photodynamic therapy. Ultrastruct Pathol 1996; 20(2): 109–29.
Andersen R, Loebel N, Hammond D, Wilson M. Treatment of periodontal disease by photodisinfection compared to scaling and root planing. J Clin Dent 2007; 18(2): 34–8.
Braun A, Dehn C, Krause F, Jepsen S. Short-term clinical effects of adjunctive antimicrobial photodynamic therapy in periodontal treatment: a randomized clinical trial. J Clin Periodontol 2008; 35(10): 877–84.
Christodoulides N, Nikolidakis D, Chondros P, Becker J, Schwarz F, Rossler R, et al. Photodynamic therapy as an adjunct to non-surgical periodontal treatment: a randomized controlled clinical trial. J Periodontol 2008; 79(9):1638–44.
Chondros P, Nikolidakis D, Christodoulides N, Rössler R, Gutknecht N, Sculean A. Photodynamic therapy as adjunct to non-surgical periodontal treatment in patients on periodontal maintenance: a randomized controlled clinical trial. Lasers Med Sci 2009; 24(5): 681–8.
Polansky R, Haas M, Heschl A, Wimmer G. Clinical effectiveness of photodynamic therapy in the treatment of periodontitis. J Clin Periodontol 2009; 36(7): 575–80.
Rühling A, Fanghänel A, Houshmand M, Kuhr A, Meisel P, Schwahn C, et al. Photodynamic therapy of persistent pockets in maintenance patients—a clinical study. Clin Oral Investig 2010; 14(6):637-44.
Pejcic A, Mirkovic D. Anti-inflammatory effect of low level laser treatment on chronic periodontitis. Med Laser App 2011; 26(1): 27–34.
Lui J, Corbet EF, Jin L. Combined photodynamic and low-level laser therapies as an adjunct to nonsurgical treatment of chronic periodontitis. J Periodont Res 2011; 46(1): 89–96.
Aykol G, Baser U, Maden I, Kazak Z, Onan U, Tanrikulu- Kucuk S, et al. The effect of low-level laser therapy as an adjunct to non-surgical periodontal treatment. J Periodontol 2011; 82(3): 481-8.
Cappuyns I, Cionca N, Wick P, Giannopoulou C, Mombelli A. Treatment of residual pockets with photodynamic therapy, diode laser, or deep scaling. A randomized, split-mouth controlled clinical trial. Lasers Med Sci 2011 Nov 22. [Epub ahead of print]
Noro Filho GA, Casarin RC, Casati MZ, Giovani EM. PDT in non-surgical treatment of periodontitis in HIV patients: a split-mouth, randomized clinical trial. Lasers Surg Med 2012; 44(4): 296–302.
Chan Y, Lai CH. Bactericidal effects of different laser wavelengths on periodontopathic germs in photodynamic therapy. Lasers Med Sci 2003; 18(1): 51–5.
de Paula Eduardo C, de Freitas PM, Esteves-Oliveira M, Aranha AC, Ramalho KM, Simões A, et al. Laser phototherapy in the treatment of periodontal disease. A review. Lasers Med Sci 2010; 25(6): 781–92.
Malik R, Manocha A, Suresh DK. Photodynamic therapy - A strategic review. Indian J Dent Res 2010; 21(2):285-91.
Soukos NS, Goodson JM. Photodynamic therapy in the control of oral biofilms. Periodontology 2000 2011; 55(1): 143–66.
Takasaki AA, Aoki A, Mizutani K, Schwarz F, Sculean A, Wang CY, et al. Application of antimicrobial photodynamic therapy in periodontal and peri-implant diseases. Periodontol 2000 2009; 51:109–40.
Atieh MA. Photodynamic therapy as an adjunctive treatment for chronic periodontitis: a meta analysis. Lasers Med Sci 2010; 25:605-13.
Copyright © 2012 J Lasers Med Sci "Powered by Open Journal Systems"
ISSN: 2008-9783/E.ISSN: 2228-6721. Published quarterly by: Laser Application in Medical Sciences Research Center