Utilização de terapia fotodinâmica antimicrobiana e laserterapia no tratamento de periodontite crônica: estudo clínico

Abstract

Periodontitis is a chronic and polymicrobial inflammatory disease characterized by gingival inflammation, pocket formation and/or gingival recession and alveolar bone destruction. The periodontitis therapy is focused in the reduction or elimination of the supragingival and subgingival microbial biofilm to prevent the disease progression. The scaling and root planing (SRP) effectiveness can be compromised by the presence of pocket depth and furcation involvement that difficult the instruments access to completely remove the biofilms deposits from the root surface. In this context, alternative antibacterial therapeutic modalities such as antimicrobial photodynamic therapy (aPDT) and low laser level therapy (LLLT) have been proposed to improve the effectiveness of periodontal treatment. However, clinical studies evaluation the efficiency of both treatment showed nondefinitive and in part contradictory results with regards its clinical and microbiological effects. Based on that, the aim of this study was evaluate the clinical effects of aPDT and LLLT after the one-stage full-mouth disinfection protocol in the periodontitis treatment. A split-mouth, randomized controlled clinical trial was conducted in 20 patients presenting at least two contralateral single-rooted teeth with probing pocket depth (PD) ≥5 mm with bleeding on probing (BOP) in single-rooted teeth. All patients were submmited to one-stage full-mouth disinfection protocol (OSFMD) wherein SRP were completed in once session associated with antiseptics. After that, the selected sites randomly received: (1) aPDT (methylene blue as a photosensitizer activated by red and infrared diodo laser), or (2) LLLT (red and infrared diodo laser). Clinical parameters were assessed at baseline and 3 months post-therapies. Both treatment groups promoted a significant reduction of SS and PS after 3 months of periodontal therapy, however, no differences were observed between the groups in regard to the clinical parameters evaluated. In conclusion, aPDT and LLLT therapy promoted improvements in periodontal clinical parameters after OSFMD protocol; however no distinct differences were found between both treatment modalities in this study.