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Six-month results following treatment of aggressive periodontitis with antimicrobial photodynamic therapy or amoxicillin and metronidazole

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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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Conflict of interest

The authors declare that they have no conflict of interest. Helbo Photodynamic Systems GmbH & Co KG, Wels, Austria provided materials for the PDT group. The study was designed, conducted, and analyzed completely independently of Helbo, as was the writing of the manuscript. The authors received no financial support.

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Authors and Affiliations

  1. Department of Periodontology, Philipps-University, 35039, Marburg, Germany

    Nicole Birgit Arweiler & Thorsten Mathias Auschill

  2. Department of Periodontology, Medical Academy Bialystok, Bialystok, Poland

    Malgorzata Pietruska, Jan Pietruski, Ana Skurska & Eva Dolińska

  3. Department of Statistics, LMU Munich, Munich, Germany

    Christian Heumann

  4. Department of Periodontology, Dental School, University of Bern, Bern, Switzerland

    Anton Sculean

Authors
  1. Nicole Birgit Arweiler
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  2. Malgorzata Pietruska
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  3. Jan Pietruski
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  4. Ana Skurska
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  5. Eva Dolińska
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  6. Christian Heumann
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  7. Thorsten Mathias Auschill
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  8. Anton Sculean
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Correspondence to Nicole Birgit Arweiler.

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Arweiler, N.B., Pietruska, M., Pietruski, J. et al. Six-month results following treatment of aggressive periodontitis with antimicrobial photodynamic therapy or amoxicillin and metronidazole. Clin Oral Invest 18, 2129–2135 (2014). https://doi.org/10.1007/s00784-014-1193-6

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  • DOI: https://doi.org/10.1007/s00784-014-1193-6

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