Efficacy of antimicrobial photodynamic therapy with chloro-aluminum phthalocyanine on periodontal clinical parameters and salivary GSH and MDA levels in patients with periodontitis

Abstract

The purpose of this study was to evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) with chloro-aluminum phthalocyanine (AlClPc) on several periodontal parameters includingsalivary glutathione (GSH) and MDA (malondialdehyde) levels in periodontal sites presenting with periodontitis. Randomized clinical trial, comprising 40 test group (TG) sites and 23 control group (CG) sites. The TG was treated with scaling and root planning (SRP) and aPDT, and CG, only with SRP. Visible plaque index [VPI], gingival bleeding index [GBI], bleeding on probing [BOP], probing depth [PD] and clinical attachment level [CAL] were calculated and saliva samples were taken at baseline (T₀), three (T₃) and six months (T₆). Data was analyzed by the Wilcoxon and Mann-Whitney tests. An intragroup analysis indicated significant differences at T₃ and T₆ for GBI, CAL and GSH only in the CG (p < 0.05). For BOP, a significant decrease was observed only in the TG between T₀ and T₆ (p = 0.008). No significant differences were observed for VPI, BOP and MDA. In the intergroup analysis, significant differences were observed for GBI at T₆ (p = 0.041), and for GSH at T₃ (p = 0.031), being higher in the TG. Although aPDT with AlClPc did not present statistically proven benefits, but the employed periodontal treatment resulted in decreased BOP, PD, CAL and MDA after 3 and 6 months of treatment. In addition, the lower need for glutathione production may initially suggest an additional benefit of AlClPc aPDT in the early reestablishment of the balance between oxidative and non-oxidative agents related to oxidative stress.

Keywords: Dental scaling; Glutathione, Antimicrobial Photodynamic Therapy; Malondialdehyde; Oxidative stress; Periodontitis; Photochemotherapy.