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

J Clin Periodontol. 2013 Aug;40(8):781-8. doi: 10.1111/jcpe.12121. Epub 2013 Jun 3.

Abstract

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.

Keywords: chronic periodontitis; cytokines; furcation defects; microbiology; periodontal pocket; photochemotherapy; root planing.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aggregatibacter actinomycetemcomitans / drug effects
  • Aggregatibacter actinomycetemcomitans / isolation & purification
  • Bacterial Load / drug effects
  • Bacteroides / drug effects
  • Bacteroides / isolation & purification
  • Chronic Periodontitis / drug therapy
  • Chronic Periodontitis / microbiology
  • Combined Modality Therapy
  • Dental Scaling / methods
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • 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
  • Middle Aged
  • Periodontal Attachment Loss / drug therapy
  • Periodontal Attachment Loss / microbiology
  • Photochemotherapy / methods*
  • Photosensitizing Agents / therapeutic use
  • Porphyromonas gingivalis / drug effects
  • Porphyromonas gingivalis / isolation & purification
  • Prospective Studies
  • Root Planing / methods
  • Treatment Outcome

Substances

  • CXCL8 protein, human
  • IL10 protein, human
  • IL4 protein, human
  • IL6 protein, human
  • Interleukin-1beta
  • Interleukin-6
  • Interleukin-8
  • Photosensitizing Agents
  • Interleukin-10
  • Interleukin-4
  • Interferon-gamma
  • Granulocyte-Macrophage Colony-Stimulating Factor