Eficácia da terapia da fotodinâmica adjuvante ao tratamento periodontal básico utilizando dois tipos de fotossensibilizantes: cloro-alumínio ftalocianina e azul de metileno

Abstract

The aPDT has been suggested as a possible adjuvant to basic periodontal therapy. In addition, different photosensitizers have been proposed in the use of Antimicrobial Photodynamic Therapy (aPDT). Objective: to evaluate the efficacy of adjuvant aPDT to the basic periodontal treatment of periodontal clinical parameters in patients with periodontitis using two photosensitizers: Chlorine-Aluminum Phthalocyanine (AlClPc) and Methylene Blue (MB). Material and Methods: this double - blind, parallel trial evaluated 35 patients: 9 in the control group (SRP only), 15 in the test group 1 (SRP + aPDT - AlClPc) and 11 in the test group 2 (SRP + aPDT - MB). Each patient had between 2 or 3 diseased periodontal sites (PS≥5mm), in a total of 89 sites. The aPDT for the two test groups was applied once only after the completion of the SRP sessions. Visible plaque index (PI), bleeding on probing (BOP), depth of probing (PD) and clinical attachment level (CAL) were evaluated before treatment at baseline and after 3 months (T3) times and 6 months (T6). For the intragroup analysis, a Kruskall Wallis test was performed, and the applied test was Mann-Whitney; already for intergroup analysis, Friedman's test was applied with post-test of Wilcoxon and Mann-Whitney. Results: An increase was observed for the PI in the control group over the six months of follow-up (p=0.003), while for the test groups significant decreases were observed throughout the evaluation times (p <0.001). For GBI, it was observed a decrease for all groups evaluated, presenting significance only between baseline and T3 for the MB-Test group (p = 0.03). For the BOP, reductions were observed over the six months of evaluation, but without statistical significance (p> 0.05). Significant PD reductions were observed for all study groups for the evaluation times (p <0.05). For CAL, clinical attachment gains were observed throughout the treatment, presenting significance only for the control group (p = 0.015) and MB-Test (p = 0.032). For the intergroup analysis, we observed a statistically significant difference only in the baseline for the PI. Conclusion: TFDA using two distinct photosensitizers, methylene blue and chloro-aluminum phthalocyanine, adjuvant to RACR did not provide additional beneficial effects on clinical periodontal parameters in patients with periodontitis.