Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
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Effects of adjunctive daily phototherapy on chronic periodontitis: a randomized single-blind controlled trial

  • Jung, Gyu-Un (Department of Periodontology, Ewha Womans University Mokdong Hospital) ;
  • Kim, Jin-Woo (Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center) ;
  • Kim, Sun-Jong (Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center) ;
  • Pang, Eun-Kyoung (Department of Periodontology, Ewha Womans University Mokdong Hospital)
  • Received : 2014.10.16
  • Accepted : 2014.12.02
  • Published : 2014.12.31
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Abstract

Purpose: The purpose of this randomized single-blind controlled trial was to elucidate the clinical and antimicrobial effects of daily phototherapy (PT) as an adjunct to scaling and root planing (SRP) in patients with chronic periodontitis. Methods: The study was conducted from December 2013 to May 2014 at Ewha Womans University Mokdong Hospital, Seoul, Korea. Forty-one patients with mild to moderate chronic periodontitis were randomly divided into two therapeutic groups in a 1:1 ratio: SRP+PT and SRP (control) groups. All participants underwent full-mouth SRP. PT was performed thrice a day for a month by using electric toothbrushes with embedded light-emitting diodes. Plaque index, gingival index, probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing were assessed before (baseline) and four weeks after (follow-up) the treatment. Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, Fusobacterium nucleatum, Parvimonas micra, Campylobacter rectus, Eikenella corrodens, Streptococcus mutans, and Streptococcus sobrinus levels were detected by a real-time polymerase chain reaction at the same points in time. Results: The clinical parameters improved in both the groups. At the follow-up assessment, PPD was significantly decreased in the SRP+PT group (P=0.00). Further, PPD and CAL showed significantly greater changes in the SRP+PT group than in the SRP group (PPD, P=0.03; CAL, P=0.04). P. gingivalis and T. forsythia levels decreased in this group, but no significant intergroup differences were noted. Conclusions: Adjunctive PT seems to have clinical benefits, but evidence of its antimicrobial effects is not sufficient. Long-term studies are necessary to develop the most effective PT protocol and compare the effectiveness of PT with and without exogenous photosensitizers.

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References

  1. Renvert S, Dahlen G, Wikstrom M. Treatment of periodontal disease based on microbiological diagnosis: relation between microbiological and clinical parameters during 5 years. J Periodontol 1996;67:562-71. https://doi.org/10.1902/jop.1996.67.6.562
  2. Haffajee AD. Systemic antibiotics: to use or not to use in the treatment of periodontal infections: that is the question. J Clin Periodontol 2006;33:359-61. https://doi.org/10.1111/j.1600-051X.2006.00916.x
  3. Darveau RP, Tanner A, Page RC. The microbial challenge in periodontitis. Periodontol 2000 1997;14:12-32. https://doi.org/10.1111/j.1600-0757.1997.tb00190.x
  4. Soukos NS, Goodson JM. Photodynamic therapy in the control of oral biofilms. Periodontol 2000 2011;55:143-66. https://doi.org/10.1111/j.1600-0757.2010.00346.x
  5. Diamond I, Granelli SG, McDonagh AF, Nielsen S, Wilson CB, Jaenicke R. Photodynamic therapy of malignant tumours. Lancet 1972; 2:1175-7.
  6. 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; 35:877-84. https://doi.org/10.1111/j.1600-051X.2008.01303.x
  7. Ge L, Shu R, Li Y, Li C, Luo L, Song Z, et al. Adjunctive effect of photodynamic therapy to scaling and root planing in the treatment of chronic periodontitis. Photomed Laser Surg 2011;29:33-7. https://doi.org/10.1089/pho.2009.2727
  8. Sigusch BW, Pfitzner A, Albrecht V, Glockmann E. Efficacy of photodynamic therapy on inflammatory signs and two selected periodontopathogenic species in a beagle dog model. J Periodontol 2005;76:1100-5. https://doi.org/10.1902/jop.2005.76.7.1100
  9. O'Neill JF, Hope CK, Wilson M. Oral bacteria in multi-species biofilms can be killed by red light in the presence of toluidine blue. Lasers Surg Med 2002;31:86-90. https://doi.org/10.1002/lsm.10087
  10. Soukos NS, Socransky SS, Mulholland SE, Lee S, Doukas AG. Photomechanical drug delivery into bacterial biofilms. Pharm Res 2000;17:405-9. https://doi.org/10.1023/A:1007568702118
  11. Balata ML, Andrade LP, Santos DB, Cavalcanti AN, Tunes Uda R, Ribeiro Edel P, et al. Photodynamic therapy associated with full-mouth ultrasonic debridement in the treatment of severe chronic periodontitis: a randomized-controlled clinical trial. J Appl Oral Sci 2013;21:208-14. https://doi.org/10.1590/1678-7757201302366
  12. Andersen R, Loebel N, Hammond D, Wilson M. Treatment of periodontal disease by photodisinfection compared to scaling and root planing. J Clin Dent 2007;18:34-8.
  13. Betsy J, Prasanth CS, Baiju KV, Prasanthila J, Subhash N. Efficacy of antimicrobial photodynamic therapy in the management of chronic periodontitis: a randomized controlled clinical trial. J Clin Periodontol 2014;41:573-81. https://doi.org/10.1111/jcpe.12249
  14. Fukui M, Yoshioka M, Satomura K, Nakanishi H, Nagayama M. Specific-wavelength visible light irradiation inhibits bacterial growth of Porphyromonas gingivalis. J Periodontal Res 2008; 43:174-8. https://doi.org/10.1111/j.1600-0765.2007.01009.x
  15. de Almeida JM, Theodoro LH, Bosco AF, Nagata MJ, Oshiiwa M, Garcia VG. Influence of photodynamic therapy on the development of ligature-induced periodontitis in rats. J Periodontol 2007; 78:566-75. https://doi.org/10.1902/jop.2007.060214
  16. Smalley JW, Birss AJ, Withnall R, Silver J. Interactions of Porphyromonas gingivalis with oxyhaemoglobin and deoxyhaemoglobin. Biochem J 2002;362(Pt 1):239-45. https://doi.org/10.1042/0264-6021:3620239
  17. Soukos NS, Som S, Abernethy AD, Ruggiero K, Dunham J, Lee C, et al. Phototargeting oral black-pigmented bacteria. Antimicrob Agents Chemother 2005;49:1391-6. https://doi.org/10.1128/AAC.49.4.1391-1396.2005
  18. Silness J, Loe H. Periodontal disease in pregnancy. II: correlation between oral hygiene and periodontal condtion. Acta Odontol Scand 1964;22:121-35. https://doi.org/10.3109/00016356408993968
  19. Loe H. The gingival index, the plaque index and the retention index systems. J Periodontol 1967;38:Suppl:610-6. https://doi.org/10.1902/jop.1967.38.6_part2.610
  20. Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J 1975;25:229-35.
  21. de Almeida JM, Theodoro LH, Bosco AF, Nagata MJ, Bonfante S, Garcia VG. Treatment of experimental periodontal disease by photodynamic therapy in rats with diabetes. J Periodontol 2008;79: 2156-65. https://doi.org/10.1902/jop.2008.080103
  22. Christodoulides N, Nikolidakis D, Chondros P, Becker J, Schwarz F, Rössler R, et al. Photodynamic therapy as an adjunct to non-surgical periodontal treatment: a randomized, controlled clinical trial. J Periodontol 2008;79:1638-44. https://doi.org/10.1902/jop.2008.070652
  23. Polansky R, Haas M, Heschl A, Wimmer G. Clinical effectiveness of photodynamic therapy in the treatment of periodontitis. J Clin Periodontol 2009;36:575-80. https://doi.org/10.1111/j.1600-051X.2009.01412.x
  24. Theodoro LH, Silva SP, Pires JR, Soares GH, Pontes AE, Zuza EP, et al. Clinical and microbiological effects of photodynamic therapy associated with nonsurgical periodontal treatment. A 6-month follow-up. Lasers Med Sci 2012;27:687-93. https://doi.org/10.1007/s10103-011-0942-x
  25. Pourabbas R, Kashefimehr A, Rahmanpour N, Babaloo Z, Kishen A, Tenenbaum HC, et al. Effects of photodynamic therapy on clinical and gingival crevicular fluid inflammatory biomarkers in chronic periodontitis: a split-mouth randomized clinical trial. J Periodontol 2014;85:1222-9. https://doi.org/10.1902/jop.2014.130464
  26. Bassir SH, Moslemi N, Jamali R, Mashmouly S, Fekrazad R, Chiniforush N, et al. Photoactivated disinfection using light-emitting diode as an adjunct in the management of chronic periodontitis: a pilot double-blind split-mouth randomized clinical trial. J Clin Periodontol 2013;40:65-72. https://doi.org/10.1111/jcpe.12024
  27. Wainwright M. Photodynamic therapy: the development of new photosensitisers. Anticancer Agents Med Chem 2008;8:280-91. https://doi.org/10.2174/187152008783961888
  28. Robinson DJ, de Bruijn HS, van der Veen N, Stringer MR, Brown SB, Star WM. Fluorescence photobleaching of ALA-induced protoporphyrin IX during photodynamic therapy of normal hairless mouse skin: the effect of light dose and irradiance and the resulting biological effect. Photochem Photobiol 1998;67:140-9. https://doi.org/10.1111/j.1751-1097.1998.tb05177.x
  29. Pfitzner A, Sigusch BW, Albrecht V, Glockmann E. Killing of periodontopathogenic bacteria by photodynamic therapy. J Periodontol 2004;75:1343-9. https://doi.org/10.1902/jop.2004.75.10.1343
  30. Sorkhdini P, Moslemi N, Jamshidi S, Jamali R, Amirzargar AA, Fekrazad R. Effect of hydrosoluble chlorine-mediated antimicrobial photodynamic therapy on clinical parameters and cytokine profile in ligature-induced periodontitis in dogs. J Periodontol 2013; 84:793-800. https://doi.org/10.1902/jop.2012.120330
  31. Nagahara A, Mitani A, Fukuda M, Yamamoto H, Tahara K, Morita I, et al. Antimicrobial photodynamic therapy using a diode laser with a potential new photosensitizer, indocyanine green-loaded nanospheres, may be effective for the clearance of Porphyromonas gingivalis. J Periodontal Res 2013;48:591-9. https://doi.org/10.1111/jre.12042
  32. Minnock A, Vernon DI, Schofield J, Griffiths J, Parish JH, Brown ST. Photoinactivation of bacteria. Use of a cationic water-soluble zinc phthalocyanine to photoinactivate both gram-negative and gram-positive bacteria. J Photochem Photobiol B 1996;32:159-64. https://doi.org/10.1016/1011-1344(95)07148-2
  33. Soukos NS, Mulholland SE, Socransky SS, Doukas AG. Photodestruction of human dental plaque bacteria: enhancement of the photodynamic effect by photomechanical waves in an oral biofilm model. Lasers Surg Med 2003;33:161-8. https://doi.org/10.1002/lsm.10208
  34. Komerik N, Wilson M, Poole S. The effect of photodynamic action on two virulence factors of gram-negative bacteria. Photochem Photobiol 2000;72:676-80. https://doi.org/10.1562/0031-8655(2000)072<0676:TEOPAO>2.0.CO;2
  35. Chui C, Aoki A, Takeuchi Y, Sasaki Y, Hiratsuka K, Abiko Y, et al. Antimicrobial effect of photodynamic therapy using high-power blue light-emitting diode and red-dye agent on Porphyromonas gingivalis. J Periodontal Res 2013;48:696-705.

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