Skip to main content

Advertisement

SpringerLink
Log in

The adjunctive effect of photodynamic therapy for residual pockets in single-rooted teeth: a randomized controlled clinical trial

  • Original Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

Abstract

Residual pockets are challenging sites that require additional periodontal therapy. The aim of this study was to evaluate the effect of a single photodynamic therapy (PDT) as an adjunct to scaling and root planning (SRP) in residual pockets in single-rooted teeth. A blind, split-mouth, randomized controlled clinical trial was conducted in systemically healthy subjects presenting at least two residual pockets (probing pocket depth (PPD) ≥5 mm with bleeding on probing (BoP)) in single root teeth in supportive periodontal therapy. The selected sites were assigned to receive (1) PDT + SRP or (2) SRP. In sites treated by PDT as adjunctive to SRP, the laser system included a handheld battery-operated diode laser with a wavelength of 660 nm, a power output of 60 mW, and energy density of 129 J/cm2, together with methylene blue as a photosensitizer (10 mg/ml). Clinical parameters were assessed at baseline and 3 months post-therapies. Clinical parameters improved significantly after both therapies (p < 0.05), whereas higher probing pocket depth reduction and clinical attachment level gain were observed in the PDT + SRP group at 3 months (p < 0.05). In addition, sites treated by the combined approach yielded a significant reduction in the number of sites with PPD <5 mm without BoP after 3 months compared to sites treated by conventional SRP alone (p < 0.05). PDT as an adjunctive to mechanical debridement demonstrated additional clinical benefits for residual pockets in single-rooted teeth and may be an alternative therapeutic strategy in supportive periodontal maintenance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ikeda N, Usuda J, Kato H, Ishizumi T, Ichinose S, Otani K, Honda H, Furukawa K, Okunaka T, Tsutsui H (2011) New aspects of photodynamic therapy for central type early stage lung cancer. Lasers Surg Med 43:749–754

    Article  PubMed  Google Scholar 

  2. Moore CM, Emberton M, Bown SG (2011) Photodynamic therapy for prostate cancer—an emerging approach for organ-confined disease. Lasers Surg Med 43:768–775

    PubMed  Google Scholar 

  3. Pinheiro SL, Donegá JM, Seabra LM, Adabo MD, Lopes T, do Carmo TH, Ribeiro MC, Bertolini PF (2010) Capacity of photodynamic therapy for microbial reduction in periodontal pockets. Lasers Med Sci 25:87–91

    Article  PubMed  Google Scholar 

  4. Theodoro LH, Silva SP, Pires JR, Soares GH, Pontes AE, Zuza EP, Spolidório DM, de Toledo BE, Garcia VG (2011) Clinical and microbiological effects of photodynamic therapy associated with nonsurgical periodontal treatment. A 6-month follow-up. Lasers Med Sci 27(4):687–693

    Article  PubMed  Google Scholar 

  5. Herrera D, Sanz M, Jepsen S, Needleman I, Roldán S (2002) A systematic review on the effect of systemic antimicrobials as an adjunct to scaling and root planing in periodontitis patients. J Clin Periodontol 29(Suppl):136–159. doi:discussion160-2

    Article  PubMed  Google Scholar 

  6. Van der Weijden GA, Timmerman MF (2002) A systematic review on the clinical efficacy of subgingival debridement in the treatment of chronic periodontitis. J Clin Periodontol 29(suppl 3):55–71

    Article  PubMed  Google Scholar 

  7. Haffajee AD, Torresyap G, Socransky SS (2007) Clinical changes following four different periodontal therapies for the treatment of chronic periodontitis: 1-year results. J Clin Periodontol 34:243–253

    Article  PubMed  CAS  Google Scholar 

  8. Ribeiro Edel P, Bittencourt S, Zanin IC, Bovi Ambrosano GM, Sallum EA, Nociti FH, Gonçalves RB, Casati MZ (2009) Full-mouth ultrasonic debridement associated with amoxicillin and metronidazole in the treatment of severe chronic periodontitis. J Periodontol 80:1254–1264

    Article  PubMed  Google Scholar 

  9. Rosling B, Serino G, Hellström MK, Socransky SS, Lindhe J (2001) Longitudinal periodontal tissue alterations during supportive therapy. Findings from subjects with normal and high susceptibility to periodontal disease. J Clin Periodontol 28:241–249

    Article  PubMed  CAS  Google Scholar 

  10. Matuliene G, Pjetursson BE, Salvi GE, Schmidlin K, Brägger U, Zwahlen M, Lang NP (2008) Influence of residual pockets on progression of periodontitis and tooth loss: results after 11 years of maintenance. J Clin Periodontol 35:685–695

    Article  PubMed  Google Scholar 

  11. Anderson GB, Palmer JA, Bye FL, Smith BA, Caffesse RG (1996) Effectiveness of subgingival scaling and root planing: single versus multiple episodes of instrumentation. J Periodontol 67:367–373

    Article  PubMed  CAS  Google Scholar 

  12. Jenkins WM, Said SH, Radvar M, Kinane DF (2000) Effect of subgingival scaling during supportive therapy. J Clin Periodontol 27:590–596

    Article  PubMed  CAS  Google Scholar 

  13. Serino G, Rosling B, Ramberg P, Hellström MK, Socransky SS, Lindhe J (2001) The effect of systemic antibiotics in the treatment of patients with recurrent periodontitis. J Clin Periodontol 28:411–418

    Article  PubMed  CAS  Google Scholar 

  14. Leung WK, Jin L, Yau JY, Sun Q, Corbet EF (2005) Microflora cultivable from minocycline strips placed in persisting periodontal pockets. Arch Oral Biol 50:39–48

    Article  PubMed  CAS  Google Scholar 

  15. König J, Schwahn C, Fanghänel J, Plötz J, Hoffmann T, Kocher T (2008) Repeated scaling versus surgery in young adults with generalized advanced periodontitis. J Periodontol 79:1006–1013

    Article  PubMed  Google Scholar 

  16. Armitage GC (1999) Development of a classification system for periodontal diseases and conditions. Ann Periodontol 4:1–6

    Article  PubMed  CAS  Google Scholar 

  17. Ainamo J, Bay I (1975) Problems and proposals for recording gingivitis and plaque. Int Dent J 25:229–235

    PubMed  CAS  Google Scholar 

  18. Muhlemann HR, Son S (1971) Gingival sulcus bleeding—a leading symptom in initial gingivitis. Helv Odontol Acta 15:107–113

    PubMed  CAS  Google Scholar 

  19. Braun A, Dehn C, Krause F, Jepsen S (2008) Short-term clinical effects of adjunctive antimicrobial photodynamic therapy in periodontal treatment: a randomized clinical trial. J Clin Periodontol 35:877–884

    Article  PubMed  CAS  Google Scholar 

  20. Chondros P, Nikolidakis D, Christodoulides N, Rössler R, Gutknecht N, Sculean A (2009) Photodynamic therapy as adjunct to non-surgical periodontal treatment in patients on periodontal maintenance: a randomized controlled clinical trial. Lasers Med Sci 24:681–688

    Article  PubMed  Google Scholar 

  21. Christodoulides N, Nikolidakis D, Chondros P, Becker J, Schwarz F, Rössler R, Sculean A (2008) Photodynamic therapy as an adjunct to non-surgical periodontal treatment: a randomized, controlled clinical trial. J Periodontol 79:1638–1644

    Article  PubMed  Google Scholar 

  22. Woodruff LD, Bounkeo JM, Brannnon WM, Dawes KD, Barham CD, Waddell DL, Enwemeka CS (2004) The efficacy of laser therapy in wound repair: a meta-analysis of the literature. Photomed Laser Surg 22:241–247

    Article  PubMed  Google Scholar 

  23. Qadri T, Miranda L, Tuner J, Gustafsson A (2005) The short-term effect of low-level laser as adjunct therapy in the treatment of periodontal inflammation. J Clin Periodontol 32:714–719

    Article  PubMed  CAS  Google Scholar 

  24. Lulic M, Leiggener Gorog I, Salvi GE, Ramseier CA, Mattheos N, Lang NP (2009) One-year outcomes of repeated adjunctive photodynamic therapy during periodontal maintenance: a proof-of-principle randomized-controlled clinical trial. J Clin Periodontol 36:661–666

    Article  PubMed  Google Scholar 

  25. Pihlstrom BL, Oliphant TH, McHugh RB (1984) Molar and nonmolar teeth compared over 6 1/2 years following two methods of periodontal therapy. J Periodontol 55:499–504

    Article  PubMed  CAS  Google Scholar 

  26. Del Peloso Ribeiro E, Bittencourt S, Nociti FH Jr, Sallum EA, Sallum AW, Casati MZ (2007) Comparative study of ultrasonic instrumentation for the non-surgical treatment of interproximal and non-interproximal furcation involvements. J Periodontol 78:224–230

    Article  PubMed  Google Scholar 

  27. Rieder C, Joss A, Lang NP (2004) Influence of compliance and smoking habits on the outcomes of supportive periodontal therapy (SPT) in a private practice. Oral Health Prev Dent 2:89–94

    PubMed  Google Scholar 

  28. Yilmaz S, Kuru B, Kuru L, Noyan U, Argun D, Kadir T (2002) Effect of gallium arsenide diode laser on human periodontal disease: a microbiological and clinical study. Lasers Surg Med 30:60–66

    Article  PubMed  Google Scholar 

  29. de Oliveira RR, Schwartz-Filho HO, Novaes AB Jr, Taba M Jr (2007) Antimicrobial photodynamic therapy in the non-surgical treatment of aggressive periodontitis: a preliminary randomized controlled clinical study. J Periodontol 78:965–973

    Article  PubMed  Google Scholar 

  30. Andersen R, Loebel N, Hammond D, Wilson M (2007) Treatment of periodontal disease by photodisinfection compared to scaling and root planing. J Clin Dent 18:34–38

    PubMed  Google Scholar 

  31. Cappuyns I, Cionca N, Wick P, Giannopoulou C, Mombelli A (2011) Treatment of residual pockets with photodynamic therapy, diode laser, or deep scaling. A randomized, split-mouth controlled clinical trial. Lasers Med Sci. doi:10.1007/s10103-011-1027-6

  32. Rühling A, Fanghänel J, Houshmand M, Kuhr A, Meisel P, Schwahn C, Kocher T (2010) Photodynamic therapy of persistent pockets in maintenance patients—a clinical study. Clin Oral Investig 14:637–644

    Article  PubMed  Google Scholar 

  33. Greenstein G (2005) Position paper: the role of supra- and subgingival irrigation in the treatment of periodontal diseases. J Periodontol 76:2015–2027

    Article  PubMed  Google Scholar 

  34. Sigusch BW, Pfitzner A, Albrecht V, Glockmann E (2005) Efficacy of photodynamic therapy on inflammatory signs and two selected periodontopathogenic species in a beagle dog model. J Periodontol 76:1100–1105

    Article  PubMed  CAS  Google Scholar 

  35. Slot DE, Kranendonk AA, Paraskevas S, Van der Weijden F (2009) The effect of a pulsed Nd:YAG laser in non-surgical periodontal therapy. J Periodontol 80:1041–1056

    Article  PubMed  Google Scholar 

  36. Eickholz P, Kim TS, Schacher B, Reitmeir P, Burklin T, Ratka Krüger P (2005) Subgingival topical doxycycline versus mechanical debridement for supportive periodontal therapy: a single blind randomized controlled two-center study. Am J Dent 18:341–346

    PubMed  Google Scholar 

  37. Tomasi C, Koutouzis T, Wennström JL (2008) Locally delivered doxycycline as an adjunct to mechanical debridement at retreatment of periodontal pockets. J Periodontol 79:431–439

    Article  PubMed  Google Scholar 

  38. McColl E, Patel K, Dahlen G, Tonetti M, Graziani F, Suvan J, Laurell L (2006) Supportive periodontal therapy using mechanical instrumentation or 2 % minocycline gel: a 12-month randomized, controlled, single masked pilot study. J Clin Periodontol 33:141–150

    Article  PubMed  CAS  Google Scholar 

  39. Bonito AJ, Lux L, Lohr KN (2005) Impact of local adjuncts to scaling and root planing in periodontal disease therapy: a systematic review. J Periodontol 76:1227–1236

    Article  PubMed  Google Scholar 

  40. Socransky SS, Haffajee AD (2002) Dental biofilms: difficult therapeutic targets. Periodontol 2000 28:12–55

    Article  PubMed  Google Scholar 

  41. Fine DH, Markowitz K, Furgang D, Goldsmith D, Ricci-Nittel D, Charles CH, Peng P, Lynch MC (2007) Effect of rinsing with an essential oil-containing mouthrinse on subgingival periodontopathogens. J Periodontol 78:1935–1942

    Article  PubMed  Google Scholar 

  42. Van Leeuwen MP, Slot DE, Van der Weijden GA (2011) Essential oils compared to chlorhexidine with respect to plaque and parameters of gingival inflammation: a systematic review. J Periodontol 82:174–194

    Article  PubMed  Google Scholar 

  43. Matisko MW, Bissada NF (1993) Short-term sequential administration of amoxicillin/clavulanate potassium and doxycycline in the treatment of recurrent/progressive periodontitis. J Periodontol 64:553–558

    Article  PubMed  CAS  Google Scholar 

  44. Haffajee AD, Uzel NG, Arguello EI, Torresyap G, Guerrero DM, Socransky SS (2004) Clinical and microbiological changes associated with the use of combined antimicrobial therapies to treat "refractory" periodontitis. J Clin Periodontol 31:869–877

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by FAPESP (São Paulo Research Foundation)—Processes 2010/51218-8.

Conflict of interest

The authors report no conflicts of interest related to this study.

Author information

Authors and Affiliations

  1. Dental Research Division, School of Dentistry, Paulista University, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, 04026-002, São Paulo, São Paulo, Brazil

    Gisele N. Campos, Suzana P. Pimentel, Fernanda V. Ribeiro, Renato C. V. Casarin, Fabiano R. Cirano, Cintia H. C. Saraceni & Márcio Z. Casati

  2. Depto de Odontologia, Universidade Paulista, UNIP, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, 04026-002, São Paulo, SP, Brazil

    Márcio Z. Casati

Authors
  1. Gisele N. Campos
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Suzana P. Pimentel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fernanda V. Ribeiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Renato C. V. Casarin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fabiano R. Cirano
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Cintia H. C. Saraceni
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Márcio Z. Casati
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Márcio Z. Casati.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Campos, G.N., Pimentel, S.P., Ribeiro, F.V. et al. The adjunctive effect of photodynamic therapy for residual pockets in single-rooted teeth: a randomized controlled clinical trial. Lasers Med Sci 28, 317–324 (2013). https://doi.org/10.1007/s10103-012-1159-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10103-012-1159-3

Keywords

Search

Navigation