The Effect of Antimicrobial Photodynamic Therapy (aPDT) with a Combination of Diode Laser and Photosensitizer in Periodontal Therapy

Abstract

Background and Objective: In recent years, there has been growing interest in the use of dental lasers for treatment of periodontal diseases. The purpose of this clinical trial was to evaluate the effects of antimicrobial photodynamic therapy (aPDT) with indocyanine green (ICG) loaded nanospheres as photosensitizer for periodontal treatment.
Material and Methods: Seventeen patients (56.1 ± 10.3 years of age) participated in this study. Intended sites were taken from periodontally involved sites with a probing depth of ≥ 5 mm totaling 51 sites. These sites were divided into three groups at random. The laser with nanospheres group consisted of 17 sites irradiated with a diode laser at 0.5 W for 90 sec per site after injecting nanospheres into the periodontal pocket. The optical fiber was inserted into the periodontal pocket 1 mm less than the probing depth with surface anesthesia and moved up and down in order to irradiate the root surface as evenly as possible. The laser group consisted of 17 sites that were irradiated with the diode laser at 0.5 W for 90 sec per site. The sham group consisted of 17 sites that were not irradiated, but the fiber was only inserted into the periodontal pockets and moved up and down. Each subject was monitored clinically at baseline, 1 month, and 3 months. Clinical parameters such as probing pocket depth (PPD), clinical attainment level (CAL), and bleeding on probing (BOP) were measured at each site with a stent.
Results: The mean value of the PPD significantly decreased in the laser with nanospheres group from 5.23 ± 0.75 to 3.71 ± 0.92 after 3 months (P < 0.001), in the laser group from 5.35 ± 0.61 to 4.24 ± 1.39 after 3 months (P < 0.01), and in the sham group from 5.53 ± 1.01 to 5.47 ± 1.18 after 3 months (NS). The mean value of CAL significantly decreased in the laser with nanospheres group from 6.00 ± 1.62 to 4.82 ± 1.55 after 3 months (P < 0.05), in the laser group from 5.88 ± 0.93 to 5.24 ± 1.30 after 3 months (NS), and in the sham group from 6.29 ± 2.14 to 6.17 ± 1.67 after 3 months (NS). BOP decreased for the laser with nanospheres group (P < 0.01) at 1 month and 3 months after treatment.
Conclusion: The results of this study show that the adjunctive application of aPDT is appropriate to improve periodontal clinical parameters.