RESUMEN
BACKGROUND: Current research aims to find alternatives to conventional methods for suppressing periodontopathogenic bacteria. Photodynamic therapy (PDT) could be a suitable treatment procedure of periodontal infections. METHODS: In the present study, the PDT method was tested with two photosensitizers, chlorine e6 and BLC1010, in an experiment on beagle dogs. The animals were infected with Porphyromonas gingivalis (Pg) and Fusobacterium nucleatum (Fn) in all subgingival areas. After infection, we observed clinical signs of gingival inflammation, including an increase of redness and bleeding on probing. Microbiological monitoring before and after treatment was performed using polymerase chain reaction (PCR). PDT was conducted with a diode laser with a wavelength of 662 nm using a power of 0.5 W and the photosensitizers. RESULTS: The PDT procedure carried out with either of the photosensitizers caused a significant reduction in the clinical inflammation signs of redness and BOP, compared to the controls (laser only and no treatment). Furthermore, PDT with chlorine e6 caused a significant reduction in P. gingivalis-infected sites, whereas there was a lack in suppression after PDT with BLC1010. F. nucleatum could hardly be reduced with chlorine e6, and only to a certain extent with BLC 1010 and laser only. In the control groups, the Pg-infected test sites did not change. CONCLUSIONS: This study demonstrated that the photodynamic therapy using photosensitizer and a 662 nm laser light source is distinctly advantageous in reducing the periodontal signs of redness and bleeding on probing. The procedure also appears to significantly suppress P. gingivalis.
Asunto(s)
Periodontitis/tratamiento farmacológico , Fotoquimioterapia , Fármacos Fotosensibilizantes/farmacología , Fármacos Fotosensibilizantes/uso terapéutico , Animales , Infecciones Bacterianas/tratamiento farmacológico , Perros , Fusobacterium nucleatum/efectos de los fármacos , Rayos Láser , Pruebas de Sensibilidad Microbiana , Periodontitis/microbiología , Porphyromonas gingivalis/efectos de los fármacosRESUMEN
BACKGROUND: Recently we described a non-surgical two-step treatment concept, in which we distinguished between a first scaling and root planing step (SRP) and an additional second enhanced root planing step (ERP). Until now it is difficult to determine how often a root surface should be instrumented during ERP. METHODS: The aim of the present study was to investigate the outcomes after different root planing intensities during ERP in 37 patients with aggressive periodontitis after SRP. During ERP a full-mouth root planing was performed. The patients were randomly assigned to one of two root planing regimens (group 1, N = 12 and group 2, N = 11), based on number of curet strokes per root surface (instrumentation frequency, IF) and probing depth. Group 1: PD 1 to 3.5 mm, 4 IF (for group 2, 8 IF); PD 4 to 6 mm, 8 IF (group 2, 14 IF); PD 6.5 to 9 mm, 12 IF (group 2, 20 IF); and PD >9 mm, 16 IF (group 2, 24 IF). Group 3 patients (controls; N = 14) received only the initial SRP. All three groups received the same adjunctive systemic antibiotic treatment. RESULTS: In all groups, the results showed statistically significant differences in PD and clinical attachment level (CAL) after 6 and 24 months compared to baseline data. Compared with the controls, a significant reduction in PD was observed in groups 1 and 2. The reduction in mean PD was distinctly greater in group 2 (higher IF). Furthermore, Porphyromonas gingivalis (Pg) and Actinobacillus actinomycetemcomitans (Aa) were completely suppressed in group 2 after 24 months. CONCLUSIONS: The present results show that the extent of root planing has a distinct influence on treatment outcomes. Patients treated with the highest instrumentation frequency showed the best long-term results.
Asunto(s)
Antiinfecciosos/administración & dosificación , Metronidazol/administración & dosificación , Periodontitis/tratamiento farmacológico , Aplanamiento de la Raíz/métodos , Adulto , Terapia Combinada , Femenino , Humanos , Masculino , Pérdida de la Inserción Periodontal , Periodontitis/microbiología , Estadísticas no Paramétricas , Factores de Tiempo , Resultado del TratamientoRESUMEN
BACKGROUND: The aim of this study was to evaluate a new approach for killing periodontopathogenic bacteria using photodynamic therapy (PDT). METHODS: In this study, we investigated the photosensitizers chlorin e6, BLC 1010, and BLC 1014 by three different methods for their effect in PDT on the viability of periodontopathogenic bacterial species. The methods included examination of inhibition zones on agar plates, determination of colony-forming units (CFU), and the use of a bacterial viability kit. RESULTS: Using the CFU method, we were able to demonstrate that the anaerobic bacteria Porphyromonas gingivalis, Fusobacterium nucleatum, and Capnocytophaga gingivalis can be photoinactivated completely by illumination with an intensity of 5.3 J/cm2 in the presence of 10 microM chlorin e6 and 10 microM BLC 1010. With the photosensitizers chlorin e6 and BLC 1010, we were able to induce zones of inhibition on agar plates. BLC 1014 failed to produce a zone of inhibition. The results of the bacterial viability test also showed that the photosensitizer BLC 1014 provides the lowest photodynamic effect in comparison to the others. CONCLUSION: The data collected to date suggest that photodynamic therapy with chlorin e6 and BLC 1010 is advantageous for suppressing periodontopathogenic bacteria.