Short-Term Effects of Antimicrobial Photodynamic Therapy as an Adjunct to Non-Surgical Periodontal Treatment in Type 2 Diabetic Individuals: A Split-Mouth Double-Blind Randomized Controlled Clinical Trial
Thayná Náthally Petry de Paula Bezerra *
Western Paraná State University, Brazil.
Erica Sabrina Zuppa
Western Paraná State University, Brazil.
Patricia Oehlmeyer Nassar
Departament of Periodontics, Western Paraná State University, Brazil.
Stefany Baldwin Buttenmuller Vilas Boas
Western Paraná State University, Brazil.
Elouíse Giordana Petry de Paula
Western Paraná State University, Brazil.
Carlos Augusto Nassar
Departament of Periodontics, Western Paraná State University, Brazil.
*Author to whom correspondence should be addressed.
Abstract
It is known that diabetic individuals with untreated periodontal disease are more predisposed to uncontrolled glycemia and the consequent development of complications related to diabetes mellitus (DM). This clinical study aimed to evaluate the response to adjunctive treatment for periodontal disease to define the most effective clinical protocol. The objective of this study was to evaluate the periodontal condition of type 2 diabetic patients and the response of periodontal tissues to two different periodontal treatments, for a short period (90 days): scaling and root planing (SRP) and scaling and root planing associated with antimicrobial Photodynamic Therapy (SRP + aPDT). For this 20 patients were evaluated in a randomized split-mouth clinical study. The inclusion criteria used were: patients of both sexes, aged 25 to 65 years, with type 2 DM (glycated hemoglobin ≥ 7%) and periodontitis Stage III or IV Grade C. All selected patients underwent non-surgical periodontal treatment and evaluated through clinical parameters: plaque index (PI), probing depth (PD), clinical attachment level (CAL) and bleeding on probing (BoP). Laboratory tests were requested (fasting blood glucose, glycated hemoglobin, and lipid profile). In addition, gingival fluid quantification was performed. The side of each treatment was defined by randomization. aPDT was performed immediately after SRP and reapplied at 7 and 14 days, using a combination of a low-power laser (660 nm) and methylene blue (10 mg/ml). Patients were evaluated for a total period of 90 days, comprising the baseline and 90 days. The results demonstrate improvement in the periodontal parameters analyzed at 90 days, with no significant difference between the SRP side and the SRP + aPDT side. However, in the gingival crevicular fluid, the treatment associated with photodynamic therapy was significantly superior (p = .05). There was a significant improvement in the value of glycated hemoglobin at 90 days compared to the baseline. We can conclude that there was an improvement in the periodontal clinical condition, but there was no predominance among the proposed treatments, besides the reduction of gingival crevicular fluid with the use of photodynamic therapy associated with scaling and root planing in a short period.
Keywords: Periodontal disease, type 2 diabetes mellitus, root scaling, photodynamic therapy