Comparison of the effects between photodynamic therapy and diode laser on severe chronic periodontitis
Objective To compare the clinical effect of photodynamic therapy(PDT)and diode laser(DL)adjuvant to scaling and root planing(SRP)in the treatment of severe chronic periodontitis.Methods 30 adult patients with severe periodontal disease were selected as study subjects.A self-controlled trial was conducted.3 quadrants were selected for each subject,and 1 molar with probing depth(PD)≥7 mm and similar lesions in each quadrant was selected as the index tooth,with a total of 90 teeth and 355 loci.3 molar teeth were randomly classified into the SRP group(SRP treatment alone,118 loci),the DL group(DL adjuvant therapy after 1 week of SRP treatment,122 loci),and the PDT group(PDT adjuvant therapy after 1 week of SRP treatment,115 loci).The PD,clinical adhesion level(CAL),positive site of bleeding on probing(BOP)and number of periodontal pathogens[porphyromonas gingivalis(P.g),actinobacillus actinomycetemcomitans(A.a)and tannerella forsythensis(T.f.)]were compared before and after treatment among the three groups.Results Before treatment,PD in SRP group,DL group and PDT group were(7.87±0.82),(7.97±0.72)and(7.93±0.83)mm;at 6 weeks after treatment,PD were(5.43±1.25),(5.17±0.79)and(5.13±0.90)mm;at 12 weeks after treatment,PD were(5.07±1.05),(4.77±0.78)and(4.73±0.83)mm.Before treatment,CAL of SRP group,DL group and PDT group were(8.37±0.49),(8.43±0.57)and(8.40±0.62)mm;at 6 weeks after treatment,CAL were(6.17±0.75),(5.78±0.62)and(5.73±0.64)mm;at 12 weeks after treatment,CAL were(5.83±0.61),(5.52±0.56)and(5.47±0.57)mm.Before treatment,there were no significant differences in PD and CAL levels among the three groups(P>0.05).At 6 and 12 weeks after treatment,the levels of PD and CAL in three groups were improved compared with those before treatment,and CAL in DL group and PDT group were better than that in SRP group(P<0.05).At 12 weeks after treatment,PD and CAL in the three groups were slightly lower than those at 6 weeks after treatment,but the difference was not statistically significant(P>0.05).At 6 weeks after treatment,the proportion of BOP positive sites in SRP group,DL group and PDT group were 78.0%,67.2%and 65.2%.At 12 weeks after treatment,the proportion of BOP positive sites in SRP group,DL group and PDT group were 77.1%,62.3%and 59.1%,which were lower than 94.1%,93.4%and 94.8%before treatment;at 12 weeks after treatment,the proportion of BOP positive sites in DL group and PDT group continued to decrease,which was lower than SRP group(P<0.05).However,there was no significant difference in percent of BOP positive sites between DL group and PDT group at 12 weeks after treatment(P>0.05).At 6 and 12 weeks after treatment,the bacterial count of P.g,A.a and T.f in the three groups were lower than those before treatment;at 6 weeks after treatment,the bacterial count of P.g,A.a and T.f in DL group and PDT group were lower than those in SRP group;at 12 weeks after treatment,the bacterial count of A.a and T.f bacteria in DL group and PDT group were lower than those in SRP group(P<0.05).However,there was no significant difference in the comparison of bacterial count of A.a and T.f between DL group and PDT group,and the comparison of P.g bacteria count among the three groups at 12 weeks after treatment(P>0.05).Conclusion PDT and DL as SRP adjuvant treatments have certain effects for severe chronic periodontitis of molar teeth in the short term,and can reduce the bacterial burden of A.a and T.f.
Chronic periodontitisPhotodynamic therapyDiode laserScaling and root planing
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