Clinical Evaluation of the Effects of Topical Indocyanine-green Mediated Photosensitiser vs Aloe Vera Gel as Adjunct Therapy to Scaling and Root Planing in Chronic Periodontitis Patients

Abstract

Purpose: To clinically evaluate and compare the efficacy of indocyanine green mediated photodynamic therapy (PDT) and aloe vera (AV) gel when used as adjunct therapy to scaling and root planing (SRP) for treatment of chronic periodontitis.

Materials and methods: One hundred fifty patients were randomly assigned to three treatment groups: group 1 (SRP), group 2 (SRP+PDT) and group 3 (SRP+AV). Four clinical parameters - plaque index (PI), bleeding on probing (BoP), periodontal (PD) pocket depth and clinical attachment level (CAL) - were evaluated at baseline and 3 and 6 months post treatment. Additionally, the amount of three inflammatory - cytokines IL-6, IL-8 and TNF-α - in gingival crevicular fluid (GCF) was identified using an enzyme-linked immune-sorbent assay (ELISA).

Result: Statistically significant improvement was observed for all clinical parameters in group 3 at follow-up in comparison to groups 1 and 2. Individuals treated with adjunct PDT showed statistically significant reduction in moderate (4-5 mm) and deep (≥6 mm) PD pockets at the 3-month follow-up. Group-2 and -3 patients displayed statistically significant reductions in cytokines IL-6, IL-8 and TNF-α at the 3-month follow-up in comparison to group 1 patients. This reduction in cytokines was maintained at the 6-month follow-up.

Conclusion: Adjunct treatment regimens PDT and AV gel statistically significantly contributed to decreasing inflammation in periodontal tissue. AV /gel showed potential to decrease BoP, whereas PDT can facilitate increasing the clinical attachment level.

Keywords: aloe vera; chronic periodontitis; photodynamic therapy; scaling and root planing.

Fig 1

Graphic representation of changes in levels of cytokines in GCF (mean ± standard deviation) pre- and post- treatment at three time points (baseline/3 and 6 months) for three treatment groups 1. IL-6 levels; 2. IL-8 levels; and 3. TNF-α levels.