Comparison between scaling-root-planing (SRP) and SRP/photodynamic therapy: six-month study

Abstract

Introduction: The purpose of this long-term clinical study was to examine the additional efficacy of photodynamic therapy (PDT) to scaling and root planing (SRP) in patients with chronic periodontal disease.

Methods: A total of 22 patients (mean age: 59.3 ± 11.7 years) with chronic periodontal disease and four teeth with probing depth ≥ 5 mm were enrolled in the study. Inclusion criteria were: no systemic disease, no smoking, no pregnancy and no long-term medication. Beside the anamnesis, the following clinical parameters were assessed at baseline (one week before therapy), and one, three and six months after the therapy: bleeding on probing (BOP), plaque index (PI) probing depth (PD), and clinical attachment loss. All measurements were done by the same examiner with a fixed periodontal probe (PCP 12, Hu-Friedy) at six measurements/tooth. In each patient, two teeth were treated with SRP alone and two teeth with SRP and PDT (Periowave, Ondine Biopharma, Vancouver, Canada). The nonparametric Wilcoxon test for paired samples was used for comparison of the effect of the two treatments (p ≤ 0.05).

Results: After both types of treatment, the number of teeth positive for BOP declined. At baseline, the CAL measured 7.2 ± 1.2 mm (SRP) or 8.1 ± 1.3 mm (SRP/PDT); one, three and six months after both types of treatment an improvement was observed. At baseline, the probing depth was 5.9 ± 0.8 mm (SRP) or 6.4 ± 0.8 mm (SRP/PDT); after six months, an improvement of 2.4 ± 0.6 mm (SRP) or 2.9 ± 0.8 mm (SRP/PDT) was found. The greater reduction of the PD, achieved by a combination of SRP/PDT, was statistically significant after six months (p = 0.007).

Conclusion: This clinical study demonstrates that SRP in combination with PDT seems to be effective and is therefore suitable as an adjuvant therapy to the mechanical conditioning of the periodontal pockets in patients with chronic periodontal diseases.

Figure 1

Patient with chronic periodontitis before treatment (left), during photodynamic therapy (middle) and six months after treatment (right).

Figure 2

Gain in the clinical attachment (mm) one month, two and three months after therapy with scaling and root planing alone (SRP) or in combination with photodynamic therapy (SRP + PDT), n = 22.

Figure 3

Improvement of probing depths (mm) one month, two and three months after therapy with scaling and root planing alone (SRP) or in combination with photodynamic therapy (SRP + PDT), n = 22.