No benefit of an adjunctive phototherapy protocol in treatment of periodontitis: A split‐mouth randomized controlled trial

Abstract

Aim: To assess the efficacy of a commercially available adjunctive phototherapy protocol ("Perio-1") in treatment of periodontitis. Materials and Methods:In an examiner-blind, randomized, controlled, split-mouth, multicentre study, 60 periodontitis patients received root surface debridement (RSD) in sextants either alone (control sextants) or with the adjunctive phototherapy protocol (test sextants). Re-evaluation was performed at 6, 12 and 24 weeks. Results:No statistically significant differences in mean (± standard deviation) clinical attachment level (CAL) change from baseline to week 24 were observed between test (−1.00 ± 1.16 mm) and control sextants (−0.87 ± 0.79 mm) at sites with probing pocket depths (PPDs) ≥5 mm ("deep sites") at baseline (p = .212). Comparisons between test and control sextants for all other parameters (CAL change at all sites, PPD change at deep sites/all sites, bleeding on probing, plaque scores), and for all change intervals, failed to identify any statistically significant differences. Conclusions:The phototherapy protocol did not provide any additional clinical benefits over those achieved by RSD alone. (German Clinical Trials Register DRKS00011229). K E Y W O R D Speriodontal debridement, periodontitis, phototherapy, randomized controlled trial Clinical RelevanceScientific rationale for the study: An adjunctive phototherapy protocol ("Perio-1") is available for treatment of periodontitis. However, there is a lack of evidence regarding the clinical efficacy of the protocol.Principal findings: Sextants treated with root surface debridement (RSD) plus the adjunctive phototherapy protocol did not demonstrate better clinical outcomes compared to sextants treated with RSD alone. Practical implications:The findings of this research do not support use of the phototherapy protocol in the treatment of periodontitis. It is important that properly designed studies that investigate mechanisms of action and clinical efficacy are performed prior to new technologies being

Influences of race/ethnicity in periodontal treatment response and bacterial distribution, a cohort pilot study

“…The treatment responses at 6 weeks after SRP in our study were comparable to the 2 reports with the same re-evaluation time points. Statistically significant differences in reduction of CAL and/or PD are detected at 6 weeks after SRP ( 55 , 56 ). The strength of this study is our emphasis on the racial disparity in treatment response 6 weeks after SRP and in distributions of P. gingivalis (a keystone pathogen in periodontitis) and S. cristatus (its arginine deiminase inhibits P. gingivalis biofilm formation).…”

Efficacy of Non-Surgical Periodontal Therapy with Adjunctive Methylene Blue and Toluidine Blue O Mediated Photodynamic in Treatment of Periodontitis: A Randomized Clinical Trial

“…However, other studies did not show any improvement in using MB- and TBO-mediated PDT in the treatment of PD [ 47 , 48 , 49 ]. These discrepancies in the results among the different studies could be associated with the difference in settings, such as the concentration of PS, period of retention of the PS within the tissue, time for biological response, pH of the environment (tissue/tooth interface), the presence of exudates and gingival fluid, and mode of PS application (irrigation, slow-release gel), in addition to the use of different methodologies, such as different optical fiber diameters and different irradiation parameters and wavelength settings [ 17 ]. In fact, the aforementioned discrepancies are the reasons for the lack of consensus on using PDT in routine periodontal therapy [ 18 ], indicating the need for standardizing the PDT treatment protocols.…”

“…PDT has been proposed as a novel tool as adjunct to RSD to treat PD, which has shown promising results in improving the clinical periodontal parameters of plaque index (PI), bleeding on probing (BOP), clinical attachment level (CAL), and probing pocket depth (PPD) [ 16 ]. However, evidence from randomized clinical trials has shown conflicting outcomes regarding the improvement in clinical periodontal parameters and periodontal pathogen elimination when PDT is used in conjunction with RSD [ 17 , 18 ]. The purpose of this study was to evaluate the efficacy of the photosensitizers, MB and TBO, as adjuncts to RSD in treatment of periodontitis.…”