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Photodynamics : is this a viable adjunctive periodontal therapy? Hatzimanolakis, Penny

Abstract

Objective: The aim of this study was to conduct a randomized in vivo clinical trial to assess the efficacy of a one time application of a phoactivated dye, methylene blue (PerioWaveTM) in treating chronic periodontal disease in humans. Material and Methods: Thirty five periodontally maintained subjects with moderate to severe chronic periodontitis were randomly divided into a control group with nonsurgical periodontal debridement (NSPD) only versus an experimental group with NSPD and antimicrobial photodynamic therapy (APT). All teeth in both groups received periodontal treatment comprising of scaling, root planing, ultrasonics and local anaesthesia. The experimental group had the qualifying sites (pockets depths greater than 4.4 mm and bleeding on probing (BOP)) treated with the PerioWaveTM system and compared to the control group. The primary endpoint was clinical attachment level (CAL) and secondary endpoints were pocket depth (PD) and BOP. The endpoints and plaque were evaluated at baseline, 6 and 12 weeks by a blinded examiner. Results: This study showed PerioWaveTM as a one time application of a cold diode laser with a wavelength of 670nm; a maximum power of 150mw; an average energy density of 20 J/cm²; a phenothiazine photosensitizer (methylene blue) in a concentration of 0.01% wt/vol; and at an optimal activation time of 60 seconds per mesiodistal surface had no statistical significance in the treated qualifying sites with regards to CAL (p=.69; p=.97) or PD (p=.14; p=.23) at 6 or 12 weeks after treatment over the NSPD group. However BOP did have a statistical significance over the control group at 6 weeks (p=.05) but not at 12 weeks (p=.47). Conclusions: In patients with advanced chronic periodontitis, CAL and PD did not show improvement with one time application of the PerioWaveTM photodynamic system over conventional NSPD. However, the lack of BOP did have a short time (6 weeks) reduction.

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