BackgroundAggressive periodontitis (AgP) is a severe form of periodontal diseases with rapid destruction of the supporting bone around teeth. The efficacy of PDT in suppressing periodontal pathogens may be crucial in adopting new protocols for the treatment of AgP. Thus, the aim of this systematic review was to investigate the possible role of PDT in the treatment of AgP as an adjunctive therapy or monotherapy.Material and MethodsA systematic search of the literature was performed. Additionally, the references from all the selected full-text studies were searched for relevant articles. Two reviewers screened independently titles and abstracts or full text copies. Quality assessment of all the included studies was held. ResultsInitial screening of electronic databases yielded 418 potentially relevant publications. After screening of the titles and full-text examination, five studies were included in the systematic review. Four publications evaluated the effects of PDT adjunctive to SRP in patients with AgP: two of them compared the clinical outcomes of SRP and PDT with a control group that received therapy with SRP and antibiotics (metronidazole and amoxicillin); two publications included SRP and PDT in the test group, and SRP alone in the control group. In one study, PDT was tested as a monotherapy compared with SRP alone.ConclusionsWithin the limitations of this review, PDT may exhibit a beneficial role in the therapy of aggressive periodontitis after repeated applications. In the future, more methodologically sound, long-term randomized clinical trials are needed to be conducted. Key words:Photodynamic therapy, periodontitis, systematic review.
BackgroundThe real clinical utility of genetic testing is the prognostic value of genetic factors in the clinical outcome of periodontal treatment and the tooth survival. A meta-analysis was undertaken to estimate the effect of a susceptible genotype to periodontitis on the clinical outcomes of non-surgical periodontal therapy and the tooth survival.Material and MethodsA systematic search of MEDLINE-Pubmed, Cochrane Library and Scopus was performed. Additionally, a hand search was done in three journals. No specific language restriction was applied. Two reviewers screened independently titles and abstracts or full text copies. Quality assessment of all the included studies was held.ResultsInitial screening of electronic databases resulted in 283 articles. Ten studies met the inclusion criteria, nine of them examined the clinical outcome, while the other one investigated the tooth survival in susceptible individuals after non-surgical periodontal therapy. Eight of included studies were selected for the meta-analysis. IL-1 positive genotypes increase the risk of tooth loss, while no association found between the bleeding on probing (BOP), clinical attachment loss (CAL) and plaque index (PI) with the genotype status. Probing pocket depth (PPD) reduction in the first three months and in long-term results found to have a significant association with the genotype.ConclusionsThere is no difference in the clinical measurements after non-surgical periodontal treatment, apart from PPD. More publications are needed to identify a cause-effect relationship. Key words:Periodontal disease, periodontitis, periodontal therapy, clinical outcome, tooth loss, susceptibility, polymorphism, genotype, meta-analysis, systematic review.
Objective The aim of this study was to investigate whether genetic susceptibility to chronic periodontitis, conferred by the presence of the IL-6 -572GG genotype or the IL-10 -592A allele, influences the outcomes following a non-surgical periodontal therapy (NSPT)over a long period of time. Material and methods Thirty-seven chronic periodontitis patients were divided into two groups according to genotype as susceptible (SCP) and non-susceptible (NSCP). All subjects were clinically evaluated at baseline and 3 years following NSPT. Blood samples were collected at baseline from the individuals who fulfilled the inclusion criteria. All participants received NSPT from a single periodontist who was blind to the genotype status of each patient. A statistical analysis was performed by comparing the variables between groups using the Mann-Whitney U test and between baseline and 3 years for each group using the Wilcoxon test. Results The mean age of the population was estimated to be 47.68±8.64 years and it included 51.4% females, 48.6% smokers, and 45.9% alcohol consumers. Following a genetic analysis, 70.3% of patients were homozygous carriers of the IL-6 -572G (IL-6 SCP), and 46.0% of them were carriers of the IL-10 -592A allele (IL-10 SCP). NSPT reduced all studied parameters (probing depth, attachment loss, bleeding on probing, percentage of sites with 4-6mm and ≥7mm pocket depth and attachment loss) to all participants, but the treatment outcome was not associated with the genotype. The SCP and NSCP individuals showed similar clinical parameters at baseline and at 3 years. Conclusions Within the limitations of this 3-year prospective cohort study in Caucasians diagnosed with chronic periodontitis, individuals susceptible to periodontal disease as determined by the presence of the IL-6 -572GG genotype or the IL-10 -592A allele showed similar treatment outcome following NSPT.
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