Efficacy of antimicrobial photodynamic therapy versus antibiotics as an adjunct to scaling and root planing for the treatment of aggressive periodontitis: a systematic review

Authors

  • Akanksha Gugale Department of Periodontics, KLE Vishwanath Katti Institute of Dental Sciences, Belagavi, Karnataka, India
  • Shaila V. Kothiwale Department of Periodontics, KLE Vishwanath Katti Institute of Dental Sciences, Belagavi, Karnataka, India
  • Shahanaz Shaik Department of Periodontics, KLE Vishwanath Katti Institute of Dental Sciences, Belagavi, Karnataka, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20241852

Keywords:

Aggressive periodontitis, Antibiotics, Antimicrobial photodynamic therapy, Scaling and root planing

Abstract

Treating aggressive periodontitis (AgP) is quite challenging. Conventional treatment for aggressive periodontitis involves systemic antibiotics (AB) with scaling and root planing (SRP). However, antimicrobial photodynamic therapy (aPDT) presents a promising alternative due to its targeted action and reduced side effects. This suggests the need to analyse and compare both treatments to determine the best approach for effective management of AgP. A systematic literature searches in three databases: PubMed, Google Scholar, and Cochrane, and a hand search of relevant scientific journals was performed. The eligible studies included randomized controlled trials (RCTs) with parallel-group design, comparing aPDT to AB as adjuncts to SRP for treating AgP. Studies published in English language between January 2003 and December 2023 were included. Studies were assessed for quality using the Cochrane risk-of-bias tool for randomized trials version 2 (RoB 2) and were classified as high-quality studies. Five RCTs meeting eligibility criteria were selected and underwent qualitative analysis. The clinical parameters assessed in studies were Pocket Probing Depth (PPD), Bleeding on Probing (BOP), and Clinical Attachment Level (CAL). Two studies reported significant improvements in all parameters with both therapies, three studies indicated a greater reduction in clinical parameters in the AB group compared to aPDT. Adjunctive use of AB with SRP results in significant clinical outcomes compared to SRP and aPDT. According to the studies of this systematic review 4-5 applications of aPDT with an interval of 7 days, and a follow-up period of 6 months are beneficial in treating AgP.

References

Armitage GC. Development of a classification system for periodontal diseases and conditions. Annals of periodontology. 1999;4(1):1-6

Armitage GC, Cullinan MP. Comparison of the clinical features of chronic and aggressive periodontitis. Periodontol 2000. 2010;53:12-27.

Henderson B, Ward JM, Ready D. Aggregatibacter (Actinobacillus) actinomycetemcomitans: a triple A* periodontopathogen? Periodontol 2000. 2010;54(1):78-105

Moreira AL, Novaes AB, Grisi MF, Taba M, Souza SL, Palioto DB, et al. Antimicrobial photodynamic therapy as an adjunct to non-surgical treatment of aggressive periodontitis: a split-mouth randomized controlled trial. J Periodontol. 2015;86(3):376-86.

Albandar JM. Aggressive and acute periodontal diseases. Periodontol 2000. 2014;65(1):7-12.

Demmer RT, Papapanou PN. Epidemiologic patterns of chronic and aggressive periodontitis. Periodontol 2000. 2010;53:28-44.

Arweiler NB, Pietruska M, Skurska A, Dolińska E, Pietruski JK, Bläs M, et al. Nonsurgical treatment of aggressive periodontitis with photodynamic therapy or systemic antibiotics. Three-month results of a randomized, prospective, controlled clinical study. Schweiz Monatsschr Zahnmed. 2013;123(6):532-44.

Renvert S, Wikström M, Dahlén G, Slots J, Egelberg J. Effect of root debridement on the elimination of Actinobacillus actinomycetemcomitans and Bacteroides gingivalis from periodontal pockets. J Clin Periodontol. 1990;17(6):345-50.

Guerrero A, Griffiths GS, Nibali L, Suvan J, Moles DR, Laurell L, et al. Adjunctive benefits of systemic amoxicillin and metronidazole in non‐surgical treatment of generalized aggressive periodontitis: a randomized placebo‐controlled clinical trial. Journal of clinical periodontology. 2005;32(10):1096-107.

Pallasch TJ. Antibiotic resistance. Dent Clin North Am. 2003;47(4):623-39.

Daniell MD, Hill JS. A history of photodynamic therapy. Aust N Z J Surg. 1991;61(5):340-8.

Joseph S, Curtis MA. Microbial transitions from health to disease. Periodontology 2000. 2021;86(1):201-9

de Oliveira RR, Schwartz‐Filho HO, Novaes AB, Taba M. Antimicrobial photodynamic therapy in the non‐surgical treatment of aggressive periodontitis: A preliminary randomized controlled clinical study. Journal of periodontology. 2007;78(6):965-73.

Deas DE, Mealey BL. Response of chronic and aggressive periodontitis to treatment. Periodontology 2000. 2010;53:154-66

Johnson JD, Chen R, Lenton PA, Zhang G, Hinrichs JE, Rudney JD. Persistence of extracrevicular bacterial reservoirs after treatment of aggressive periodontitis. Journal of periodontology. 2008;79(12):2305-12.

Andere NM, Castro dos Santos NC, Araujo CF, Mathias IF, Taiete T, Casarin RC, et al. Clarithromycin as an adjunct to one‐stage full‐mouth ultrasonic periodontal debridement in generalized aggressive periodontitis: a randomized controlled clinical trial. Journal of periodontology. 2017;88(12):1244-52.

Haas AN, De Castro GD, Moreno T, Susin C, Albandar JM, Oppermann RV, Rösing CK. Azithromycin as an adjunctive treatment of aggressive periodontitis: 12‐months randomized clinical trial. Journal of clinical periodontology. 2008;35(8):696-704.

Nichols WW, Evans MJ, Slack MP, Walmsley HL. The penetration of antibiotics into aggregates of mucoid and non-mucoid Pseudomonas aeruginosa. Microbiology. 1989;135(5):1291-303.

Carvalho VF, Andrade PV, Rodrigues MF, Hirata MH, Hirata RD, Pannuti CM, et al. Antimicrobial photodynamic effect to treat residual pockets in periodontal patients: a randomized controlled clinical trial. Journal of Clinical Periodontology. 2015;42(5):440-7.

Skalerič E, Petelin M, Gašpirc B. Antimicrobial photodynamic therapy in treatment of aggressive periodontitis (stage III, grade C periodontitis): A comparison between photodynamic therapy and antibiotic therapy as an adjunct to non-surgical periodontal treatment. Photodiagnosis and Photodynamic Therapy. 2023;41:103251

Al-Khureif AA, Mohamed BA, Siddiqui AZ, Khan AA, Divakar DD. Repeated application of photodynamic and antibiotic therapy as an adjunct to root surface debridement in patients with grade C and stage III or IV aggressive periodontitis. Photodiagnosis and Photodynamic Therapy. 2020;29:101610.

Andere NM, Dos Santos NC, Araujo CF, Mathias IF, Rossato A, de Marco AC, et al. Evaluation of the local effect of nonsurgical periodontal treatment with and without systemic antibiotic and photodynamic therapy in generalized aggressive periodontitis. A randomized clinical trial. Photodiagnosis and Photodynamic Therapy. 2018;24:115-20.

Arweiler NB, Pietruska M, Pietruski J, Skurska A, Dolińska E, Heumann C, et al. Six-month results following treatment of aggressive periodontitis with antimicrobial photodynamic therapy or amoxicillin and metronidazole. Clinical oral investigations. 2014;18:2129-35.

Polansky R, Haas M, Heschl A, Wimmer G. Clinical effectiveness of photodynamic therapy in the treatment of periodontitis. Journal of clinical periodontology. 2009;36(7):575-80.

Kwiatkowski S, Knap B, Przystupski D, Saczko J, Kędzierska E, Knap-Czop K, et al. Photodynamic therapy–mechanisms, photosensitizers and combinations, Biomedicine & Pharmacotherapy. 2018;106:1098-107.

Luan XL, Qin YL, Bi LJ, Hu CY, Zhang ZG, Lin J, et al. Histological evaluation of the safety of toluidine blue-mediated photosensitization to periodontal tissues in mice. Lasers in medical science. 2009;24:162-6.

Sbordone L, Ramaglia L, Gulletta E, Iacono V. Recolonization of the subgingival microflora after scaling and root planing in human periodontitis. Journal of Periodontology. 1990;61(9):579-84

Rabelo CC, Feres M, Gonçalves C, Figueiredo LC, Faveri M, Tu YK, et al. Systemic antibiotics in the treatment of aggressive periodontitis. A systematic review and a Bayesian Network meta‐analysis. Journal of clinical periodontology. 2015;42(7):647-57.

Lulic M, Leiggener Görög I, Salvi GE, Ramseier CA, Mattheos N, Lang NP. One‐year outcomes of repeated adjunctive photodynamic therapy during periodontal maintenance: a proof‐of‐principle randomized‐controlled clinical trial. Journal of clinical periodontology. 2009;36(8):661-6.

Sgolastra F, Petrucci A, Severino M, Graziani F, Gatto R, Monaco A. Adjunctive photodynamic therapy to non‐surgical treatment of chronic periodontitis: a systematic review and meta‐analysis. Journal of clinical periodontology. 2013;40(5):514-26.

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Published

2024-06-28

How to Cite

Gugale, A., Kothiwale, S. V., & Shaik, S. (2024). Efficacy of antimicrobial photodynamic therapy versus antibiotics as an adjunct to scaling and root planing for the treatment of aggressive periodontitis: a systematic review. International Journal Of Community Medicine And Public Health, 11(7), 2878–2886. https://doi.org/10.18203/2394-6040.ijcmph20241852

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Section

Systematic Reviews