[Implementation of transgingival antibacterial photodynamic therapy (PDT) supplementary to scaling and root planing. A controlled clinical proof-of-principle study].

Gérald Mettraux, Jürg Hüsler
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Abstract

Background: The antibacterial photodynamic therapy (PDT) has been effective in the periodontal therapy. The laser light application reported in the literature so far is the subgingival placement of a light fibre.

Objectives: To study the effect of PDT with a transgingival laser application.

Materials and methods: In 19 patients with untreated periodontitis 1 test and 1 control site were selected. Both pockets were treated by scaling, root planing. the Test site received additional PDT (LASOTRONIC MED 701 by ORCOS MEDICAL, Switzerland) at baseline, after 2 and 6 months. The control sites were rinsed with ringer solution. Clinical parameters (ST, BOP, CAL) and bacterial monitoring (PADO, IAI, Switzerland) at baseline, 2 and 6 months were recorded.

Results: Mean pocket reduction was after 6 months 2.1 mm (+/-1.4) in the test group, 1.5 mm (+/-1.6) in the control group significantly different. The 95% confidence interval for the difference of the mean reductions of the test and control group after 6 months is (1.5, 3). Mean CAL gain after 6 months was 1.5 mm (+/-1.3) in the test, 0.9 mm (+/-1.7) in the control group. T. denticola showed lower number after 2 and 6 months in the test versus the control. The total bacterial load (TBL) showed significantly better reduction in the test group at 6 months.

Conclusions: The transgingival application of PDT with the MED 701 showed clinical and bacteriological effects which are comparable to those reported in the literature with the subgingival method. The transgingival method is convenient, harmless and easy to perform.

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[实施经龈抗菌光动力治疗(PDT),辅助洗牙和刨根。]一项对照临床原理证明研究]。
背景:抗菌光动力疗法(PDT)在牙周治疗中具有较好的疗效。到目前为止,文献中报道的激光应用是在牙龈下放置光纤维。目的:探讨经龈激光应用PDT的效果。材料与方法:19例未经治疗的牙周炎患者,选择1个试验点和1个对照点。两袋均经除垢、刨根处理。2个月和6个月后,试验点在基线时接受额外的PDT治疗(瑞士ORCOS MEDICAL公司的LASOTRONIC MED 701)。对照部位用林格液冲洗。记录基线、2个月和6个月的临床参数(ST、BOP、CAL)和细菌监测(PADO、IAI、瑞士)。结果:6个月后,实验组的平均袋缩小量为2.1 mm(+/-1.4),对照组为1.5 mm(+/-1.6),差异有统计学意义。试验组与对照组6个月后平均减少量差异的95%置信区间为(1.5,3)。试验组6个月后平均CAL增加量为1.5 mm(+/-1.3),对照组为0.9 mm(+/-1.7)。试验2个月和6个月后,小齿田鼠数量均低于对照组。6个月时,试验组的总细菌载量(TBL)明显下降。结论:经龈应用PDT与MED 701的临床和细菌学效果与文献报道的龈下方法相当。经龈法简便、无害、易操作。
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[The state of the art of endodontics]. Patients with oral tumors. Part 1: Prosthetic rehabilitation following tumor resection. Nonsurgical treatment of aggressive periodontitis with photodynamic therapy or systemic antibiotics. Three-month results of a randomized, prospective, controlled clinical study. [Infection after dental intervention. Iatrogenic or general medical cause? Case report]. Patients with oral tumors. Part 1: Prosthetic rehabilitation following tumor resection.
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