The effect of antimicrobial photodynamic therapy on periodontal disease and glycemic control in patients with type 2 diabetes mellitus

Abstract

Objectives: This study is aimed at determining the effect of concomitant antimicrobial photodynamic therapy (aPTD) on periodontal disease and glycaemic control in patients with type 2 diabetes mellitus (T2DM).

Materials and methods: Twenty-four patients with T2DM were enrolled in the study. Periodontal clinical parameters were assessed by measuring probing pocket depth (PPD), clinical attachment loss (CAL), gingival recession (GR), full-mouth bleeding score (FMBS), full-mouth plaque score (FMPS), and full-mouth sulcus bleeding score (FMSBS). Glycated haemoglobin A1c (HbA1c) was measured. To determine the presence of the following periodontal pathogenic bacteria, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, subgingival plaque samples were taken from two periodontal pockets per jaw with the greatest PPD using paper tips. Patients were randomly divided into the test and control group. In the test group, full-mouth disinfection was performed in combination with aPTD. In the control group, only full-mouth disinfection was performed.

Results: The results showed an improvement in periodontal clinical parameters in both groups. The difference between the groups in favour of the test group was statistically significant for BOP. The HbA1c level decreased in both groups. The difference was not statistically significant. The results of the microbiological analysis suggest that the presence of periodontal pathogenic bacteria is lower with additional antimicrobial photodynamic therapy with statistically significant difference for T. forsythia.

Conclusions: Additional aPDT causes a significant reduction in BoP in the proportion of positive sites for periodontal pathogens.

Trial registration: ClinicalTrials.gov ID: NCT05816941.

Clinical relevance: aPTD is a noninvasive adjunctive therapy that can positively influence the periodontal treatment outcome.

Keywords: Antimicrobial photodynamic therapy; Indocyanine green; Periodontal disease; Type 2 diabetes mellitus.

Fig. 1

Consort flow diagram

Fig. 2

The proportion of periodontal pathogenic bacteria in the test (T) and the control (C) groups on the initial exam and after 3 months (A.a., Aggregatibacter actinomycetemcomitans; P.g., Porphyromonas gingivalis; P.i., Prevotella intermedia; T.d., Treponema denticola; T.f., Tannerella forsythia; PP, baseline; K, 3 months; ZDR, test group; K, control group)

Fig. 3

The level of HbA1c in the test and the control groups at baseline and after 3 months