Single or repeated antimicrobial photodynamic therapy as adjunct to ultrasonic debridement in residual periodontal pockets: clinical, microbiological, and local biological effects
Single or repeated antimicrobial photodynamic therapy as adjunct to ultrasonic debridement in residual periodontal pockets: clinical, microbiological, and local biological effects
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DOI：
10.1007/s10103-013-1337-y
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发表时间：
2015-01-01
影响因子：
2.1
通讯作者：
Mombelli, Andrea
中科院分区：
文献类型：
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作者：
Campanile, Veronique S. Mueller;Giannopoulou, Catherine;Mombelli, Andrea
本研究旨在评估超声器械在1周间隔内进行一次或两次的抗菌光动力疗法(PDT)在残留牙周袋中的临床、微生物和局部生物学效应。采用单中心、三臂随机纵向研究，为期6个月。研究对象为28名系统健康的牙周保健者，均接受牙周残留袋(袋深度为千分之5 mm，临床附着丧失为千分之2 mm，探诊时出血(BOP+))的维持治疗。三颗牙齿上的剩余口袋被至少另外两颗牙齿隔开，作为研究地点。超声清创后，随机分为PDT组(A组)、PDT单次组(B组)和假手术组(C组)。亚甲基蓝被涂上，并将冲洗器的尖端钝化到口袋里。利用引入口袋中的光扩散尖端，用波长为670 nm的激光照射部位。A、B、C组初始PD分别为5.9+/-0.9、6.3+/-1.3、6.3+/-1.5 mm，差异无统计学意义。帕金森病各组均显著降低。在3个月时，A组(2.9+/-1.1 mm；p=0.04)和B组(2.8+/-1.1 mm；p=0.03)的PD显著低于C组(3.5+/-1.2 mm)。在6个月时，A组中没有一个部位有Pd>；4 mm和BOP+，而B组中有2个部位和C组中有4个部位留在这一类别中。从基线到3个月或6个月，所研究的微生物在>；1,000和>；100.000个/毫升的检测频率在任何组中都没有显著变化。从基线到第6个月，C反应蛋白、血清淀粉样蛋白A、纤维蛋白原、降钙素原和α2巨球蛋白的总体水平显著下降。当分别观察两组时，只有当激光被激活两次时，C反应蛋白才显著降低(p<；0.05)。两组之间的其他差异并不显著。单次或双次PDT比单独使用超声仪器有一些额外的好处。
This study aims to assess in residual periodontal pockets the clinical, microbiological, and local biological effects of antimicrobial photodynamic therapy (PDT), delivered after ultrasonic instrumentation either once or twice in a 1-week interval. A single center, three-arm randomized longitudinal study was carried out for 6 months. Twenty-eight systemically healthy patients on periodontal maintenance with residual pockets (pocket depth (PD) a parts per thousand yen5 mm, clinical attachment loss a parts per thousand yen2 mm, and bleeding upon probing (BOP+)) were included. Residual pockets on three teeth, separated from each other by at least two other teeth, served as study sites. After ultrasonic debridement, they were randomly assigned to either PDT delivered twice within 1 week (group A), PDT delivered only once (group B), or sham treatment without activating the laser (group C). Methylene blue was applied with a blunt irrigator tip into the pockets. Sites were irradiated with laser light at a wavelength of 670 nm using a light-diffusing tip introduced into the pocket. Initial PD was 5.9 +/- 0.9, 6.3 +/- 1.3, and 6.3 +/- 1.5 mm in groups A, B, and C, respectively, differences being nonsignificant. PD was significantly reduced in all groups. At month 3, PD was significantly lower in groups A (2.9 +/- 1.1 mm; p = 0.04) and B (2.8 +/- 1.1 mm; p = 0.03) compared to group C (3.5 +/- 1.2 mm). At month 6, none of the sites in group A had persisting pockets PD > 4 mm and BOP+, whereas two sites in group B and four sites in group C stayed in this category. Detection frequencies of the studied microorganisms at > 1,000 and > 100.000 cells/ml did not change significantly from baseline to months 3 or 6 in any group. A significant overall decrease was observed from baseline to month 6 for C-reactive protein, serum amyloid A, fibrinogen, procalcitonin, and alpha-2 macroglobulin. When looking at the groups separately, C-reactive protein was significantly lower only if the laser had been activated twice (p < 0.05). Other differences between groups were not significant. A single or double episodes of PDT had some additional benefit over ultrasonic instrumentation alone.