Photodynamic therapy in the treatment of class II furcation: a randomized controlled clinical trial

• Published in: Journal of clinical periodontology Vol. 40; no. 8; pp. 781 - 788
• Main Authors: Luchesi, Vanessa H., Pimentel, Suzana P., Kolbe, Maria F., Ribeiro, Fernanda V., Casarin, Renato C., Nociti Jr, Francisco H., Sallum, Enilson A., Casati, Marcio Z.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.08.2013
• Subjects: Aggregatibacter actinomycetemcomitans - drug effects; Aggregatibacter actinomycetemcomitans - isolation & purification; Bacterial Load - drug effects; Bacteroides - drug effects; Bacteroides - isolation & purification; chronic periodontitis; Chronic Periodontitis - drug therapy; Chronic Periodontitis - microbiology; Combined Modality Therapy; cytokines; Dental Scaling - methods; Dentistry; Double-Blind Method; Female; Follow-Up Studies; furcation defects; Furcation Defects - classification; Furcation Defects - drug therapy; Furcation Defects - microbiology; Granulocyte-Macrophage Colony-Stimulating Factor - analysis; Humans; Interferon-gamma - analysis; Interleukin-10 - analysis; Interleukin-1beta - analysis; Interleukin-4 - analysis; Interleukin-6 - analysis; Interleukin-8 - analysis; Lasers, Semiconductor - therapeutic use; Male; microbiology; Middle Aged; Periodontal Attachment Loss - drug therapy; Periodontal Attachment Loss - microbiology; periodontal pocket; photochemotherapy; Photochemotherapy - methods; Photosensitizing Agents - therapeutic use; Porphyromonas gingivalis - drug effects; Porphyromonas gingivalis - isolation & purification; Prospective Studies; root planing; Root Planing - methods; Treatment Outcome; periodontal pocket; chronic periodontitis; photochemotherapy; furcation defects; microbiology; cytokines; root planing
• ISSN: 0303-6979; 1600-051X
• DOI: 10.1111/jcpe.12121

Aim To investigate the effect of photodynamic therapy (PDT) as adjunct to mechanical therapy in furcations. Materials and Methods A double‐blind, parallel, randomized controlled clinical trial was conducted in subjects presenting class II furcations. The subjects were randomly allocated to a test (PDT; n = 16) or control group (non‐activated laser/only photosensitizer; n = 21). At baseline, 3 and 6 months, clinical, microbiological and cytokine pattern evaluation was performed. Clinical attachment level was defined as the primary outcome variable. Results Clinical parameters improved after both therapies (p < 0.05) with no differences between groups at any time point (p > 0.05). At 6 months, real‐time PCR evaluation showed a decrease in Porphyromonas gingivalis and Tannerella forsythia only in the PDT group (p < 0.05) with no inter‐group differences. Regarding cytokines, IL‐4 and IL‐10 levels increased in both groups at 6 months. GM‐CSF, IL‐8, IL‐1β and IL‐6 levels decreased only in the PDT group after 3 months (p < 0.05). At 3 months, inter‐group analyses showed that GM‐CSF, IFN‐γ, IL‐6 and IL‐8 levels were lower in the PDT group. At 6 months, lower IL‐1β levels were also observed in the PDT group (p < 0.05). Conclusion Photodynamic therapy did not promote clinical benefits for class II furcations; however, advantages in local levels of cytokines and a reduction in periodontopathogens were demonstrated.