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Randomized Controlled Trial
. 2017 Sep 25;7(1):12247.
doi: 10.1038/s41598-017-12514-0.

Adjunctive antimicrobial chemotherapy based on hydrogen peroxide photolysis for non-surgical treatment of moderate to severe periodontitis: a randomized controlled trial

Taro Kanno  1 , Keisuke Nakamura  2 , Kirika Ishiyama  3 , Yasutomo Yamada  4 , Midori Shirato  3 , Yoshimi Niwano  3 , Chie Kayaba  5 , Koji Ikeda  5 , Airi Takagi  6 , Takuhiro Yamaguchi  6 , Keiichi Sasaki  7
Affiliations
Randomized Controlled Trial

Adjunctive antimicrobial chemotherapy based on hydrogen peroxide photolysis for non-surgical treatment of moderate to severe periodontitis: a randomized controlled trial

Taro Kanno et al. Sci Rep. .

Abstract

Treatment of severe periodontitis with non-surgical therapy remains challenging in dentistry. The present study aimed to evaluate the clinical efficacy of hydrogen peroxide (H2O2) photolysis-based antimicrobial chemotherapy adjunctively performed with root debridement (RD) for moderate to severe periodontitis. A randomized controlled trial was conducted that included 53 patients with 142 test teeth. The test teeth were randomly assigned to one of three treatment groups: Group 1, RD + H2O2 photolysis; Group 2, RD followed by administration of a local drug delivery system (minocycline chloride gel); or Group 3, RD alone. Clinical and microbiological examination were performed for up to 12 weeks following treatment. Probing pocket depth (PPD) and bleeding on probing (BoP) were improved after each treatment session. At 12 weeks, Group 1 had achieved significantly lower PPDs than the other groups, though there were no significant differences in BoP between Group 1 and the other groups. Counts of Porphyromonas gingivalis, a known periodontal pathogen, in Group 1 were significantly lower than those in Group 3, and were comparable to those in Group 2. Therefore, it is suggested that H2O2 photolysis treatment can be used as a novel adjunctive antimicrobial chemotherapy for non-surgical periodontal treatment.

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Conflict of interest statement

Drs. Kanno and Nakamura report receiving personal fees from AZ Co. Ltd. Drs. Nakamura, Ishiyama, Shirato, and Niwano are members of a donated fund laboratory at Tohoku University Graduate School of Dentistry, which receives funding from AZ. Co. Ltd. The therapeutic devices used in the present study were made by AZ Co. Ltd. according to the specifications given by the authors. AZ Co. Ltd. as well as the funder had no role in the study design, data collection and interpretation, or the decision to submit the work for publication.

Figures

Figure 1
Figure 1
Changes in the total bacterial (a) and Porphyromonas gingivalis (b) counts after each treatment. Microbiological analysis was conducted with the invader-PCR technique. The values and error bars represent the means and 95% confidence intervals, respectively. Significant differences detected between Groups 1 and 3 are denoted by *P < 0.05 and **P < 0.01. Group 1, root debridement + H2O2 photolysis; Group 2, root debridement + local drug delivery system; and Group 3, root debridement alone.
Figure 2
Figure 2
The CONSORT flow chart for this study.
Figure 3
Figure 3
Photographic images and illustrations of the RP-14 device (a) used in the present clinical trial for periodontal treatment (b). The RP-14 is equipped with an ultrasonic scaler and a laser unit that emits light at a wavelength of 405 nm. The hollow-type, steel scaler tip and disposable plastic optical guide were used for treatment in Group 1 (root debridement + H2O2 photolysis treatment). Laser light at 50 mW and 3% H2O2 are released from the end of the scaler tip. As a result, hydroxyl radicals are generated in the periodontal pocket during root debridement.
See this image and copyright information in PMC

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