Eficácia da terapia fotodinâmica antimicrobiana com cloroalumínio ftalocianina nos parâmetros clínicos periodontais e níveis salivares de GSH e MDA em pacientes com periodontite crônica

Abstract

Antimicrobial photodynamic therapy (TFDA) with chloro-aluminum phthalocyanine (AlClFc) has been suggested as an adjunct to periodontal scaling and root coronal smoothing therapy (RACR), but it lacks further clinical studies. Objective: To evaluate the efficacy of AlClFc TFDA in periodontal clinical parameters and salivary levels of oxidative stress markers - Glutathione (GSH) and Malondialdehyde (MDA) - in patients with chronic periodontitis. Methods: This randomized, double-blind, parallel, longitudinal, and prospective trial evaluated 22 patients: 14 in the test group (RACR + TFDA) and 8 in the control group (RACR only). Each patient had at least 2 diseased periodontal sites (PS≥5mm), totaling 63 sites. The TFDA was applied once only after the completion of the RACR sessions. The indexes of oral hygiene - visible plaque index [IPV], gingival bleeding index [ISG], and periodontal clinical parameters - bleeding to probing [SS], depth of probing [PS] and level of clinical insertion [NIC] - were evaluated before treatment at T0, and after 3 months (T3) and 6 months (T6) times. Saliva samples were collected at each study time for GSH and MDA dosing. Data were statistically analyzed using non-parametric Wilcoxon and Mann-Whitney tests, with a significance level of 5% being pre-established. Results: The intragroup analysis showed statistically significant difference between the T0, T3 and T6 times (p <0.05) for the ISG, NIC and GSH variables only in the control group. For PS, there was a significant decrease in the median in the test group between T0 (5.49) and T6 (4.33), (p1 = 0.008). In the control group there was also a significant difference between the three times, but it was not possible to identify among which there was this difference. For the other IPV, SS and MDA variables there was no significant difference between the times in the two groups. In the intergroup analysis, there was a statistically significant difference for ISG in T6 (p2 = 0.041), and for GSH in T3 (p2 = 0.031), both of which were higher in the test group. For the other variables, there were no statistically significant differences between the two groups. Conclusion: TFAP with the adjuvant AlClFc photosensitizer to RACR did not confer additional benefits on periodontal clinical parameters nor on salivary concentrations of GSH and MDA after 6 months of treatment.