A Randomized Controlled Microbiological Trial on Efficacy of Photodynamic and Low- Level Laser Therapies As An Adjunct To Nonsurgical Treatment of Chronic Periodontitis

摘要

Background: The oral cavity is colonized by a large numberand highly diversified communities of micro-organisms.Bacterial biofilm on tooth or root surface is a major cause ofgingivitis and periodontitis. A novel approach, photodynamictherapy (PDT), could be a solution to these problems. Theadvantage of this new approach includes rapid bacterialelimination, minimal chance of resistance development andsafety of adjacent host tissue and normal micro flora. Recentpreclinical and clinical data have suggested a potential benefitof photodynamic therapy (PDT) in the treatment of periodontitis.Aim: The aim of this study was to evaluate the microbiologicaleffects of adjunctive use of PDT & combination of PDT withlow-level laser therapy (LLLT) to non-surgical mechanicaltherapy (SRP) in the treatment of chronic periodontitis.Methods: Twenty-four patients with untreated chronicperiodontitis were randomly assigned in a split-mouth designinto three treatment groups which included: Group I: SRP only,Group II: SRP &PDT [1% Methylene Blue solution], Group III:SRP, PDT & LLLT. Microbiologic evaluation was done to assessthe percentage of morphologically different microorganismsusing dark field microscopic examination at baseline, 1, 3 and 6months following therapy.Results: All 3 therapies resulted in significant improvementsfrom baseline in microbiological parameters. The improvementin microbiological parameters (cocci, bacilli &spirochetes) wassignificantly greater in Group III compared to Group II andGroup I.Conclusion: The present study suggests that all the 3 treatmentstrategies seem to benefit the patients; an additional applicationof low-level laser therapy to single episode of PDT could bebeneficial adjunct to nonsurgical treatment of chronicperiodontitis in terms of percentage reduction of spirochetescompared to the other two groups. Direct subgingival deliveryof methylene blue in different concentrations should beperformed to further investigate the potential antimicrobialeffect of soft lasers in human periodontal disease.