Six-month results following treatment of aggressive periodontitis with antimicrobial photodynamic therapy or amoxicillin and metronidazole
Date:
04 Feb 2014
Abstract
Objective
The
use of antibacterial photodynamic therapy (aPDT) additionally to
scaling and root planing (SRP) has been shown to positively influence
the clinical outcomes. However, at present, it is unknown to what extent
aPDT may represent a potential alternative to the use of systemic
antibiotics in nonsurgical periodontal therapy in patients with
aggressive periodontitis (AP). The aim of this study was to evaluate the
outcomes following nonsurgical periodontal therapy and additional use
of either aPDT or amoxicillin and metronidazole (AB) in patients with
AP.
Material and methods
Thirty-six
patients with AP displaying at least three sites with pocket depth (PD)
≥6 mm were treated with SRP and either systemic administration of AB
for 7 days or with two episodes of aPDT. The following clinical
parameters were evaluated at baseline and at 6 months: plaque index
(PI), bleeding on probing (BOP), PD, gingival recession (GR) and
clinical attachment level (CAL).
Results
Thirty-five
patients have completed the 6-month evaluation. At 6 months, mean PD
was statistically significantly reduced in both groups (from 5.0 ± 0.8
to 3.0 ± 0.6 mm with AB and from 5.1 ± 0.5 to 3.9 ± 0.8 mm with aPDT (p < 0.001)). AB yielded statistically significantly higher improvements in the primary outcome parameter PD (p < 0.001) when compared to aPDT. The number of pockets ≥7 mm was reduced from 141 to 3 after AB (p < 0.001) and from 137 to 45 after aPDT (p = 0.03). Both therapies resulted in statistically significant reductions in all parameters compared to baseline.
Conclusion
While
both treatments resulted in statistically significant clinical
improvements, AB showed statistically significantly higher PD reduction
and lower number of pockets ≥7 mm compared to aPDT.
Clinical relevance
In
patients with AP, the two times application of aPDT in conjunction with
nonsurgical periodontal therapy cannot be considered an alternative to
the systemic use of amoxicillin and metronidazole.
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