Treatment of Periodontitis in Smokers with Multiple Sessions of Antimicrobial Photodynamic Therapy or Systemic Antibiotics: A Randomized Clinical Trial

Publication date: Available online 10 April 2018
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Letícia Helena Theodoro, Naida Zanini Assem, Mariéllen Longo, Márcio Luiz Ferro Alves, Cristiane Duque, Rafael Nobrega Stipp, Natália Leal Vizoto, Valdir Gouveia Garcia
BackgroundThe aim of this study was to evaluate the effects of non-surgical periodontal therapies on smokers with chronic periodontitis, involving multiple adjunctive applications of antimicrobial photodynamic therapy (aPDT), and systemic metronidazole (MTZ) with amoxicillin (AMX).MethodsAll participants were treated with scaling and root planing (SRP). Seventeen patients received 400 mg of MTZ and 500 mg of AMX three times per day for 7 days (MTZ + AMX). Additionally, 17 patients received a placebo, and 17 patients were treated with three applications of aPDT (immediately, 48 hours and 96 hours after SRP). Clinical and microbiological examinations were performed at baseline and at 90 and 180 days post-therapy. Subgingival samples were analyzed using real-time polymerase chain reaction.ResultsAfter 180 days, the patients in groups MTZ + AMX and aPDT had significantly lower mean probing depths, more clinical attachment level gains and less bleeding on probing. At 180 days, in the moderate pocket there was a reduction in the levels of Porphyromonas gingivalis and Prevotella nigrescens in the MTZ + AMX group, while group aPDT showed a reduction in Prevotella nigrescens. Furthermore, at 180 days, in the deep pocket a reduction in Porphyromonas gingivalis, Prevotella intermedia and Prevotella nigrescens was observed in group MTZ + AMX, as well as a reduction in the levels of Prevotella intermedia and Prevotella nigrescens in group aPDT.ConclusionIn smokers with periodontitis, the MTZ + AMX and aPDT treatments significantly improved the effects of SRP.



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