Efficacy of Antimicrobial Photodynamic Therapy as an Adjunct to Non-Surgical Periodontal Therapy in Stage II Periodontitis: A Randomized Split-Mouth Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 30
- 试验地点
- 1
研究概览
简要总结
Gum disease (periodontitis) affects millions of people worldwide and can lead to tooth loss if untreated. The standard treatment is a deep cleaning procedure called non-surgical periodontal therapy (NSPT), where a dentist removes bacterial buildup from beneath the gums. Sometimes, harmful bacteria remain after this cleaning and the disease can return.
This study tests whether adding a light-based antibacterial treatment - called photodynamic therapy (PDT) - to the standard deep cleaning improves results. PDT works by placing a harmless green dye (indocyanine green) into the gum pocket, then shining a specific laser light on it. The light activates the dye and kills the remaining bacteria without antibiotics.
Who can join: Adults aged 18 and over diagnosed with moderate gum disease (Stage II periodontitis) with gum pocket depths of 4-5 mm.
How it works: Each participant receives both treatments - standard cleaning on one side of the mouth, and standard cleaning plus PDT on the other side. This allows a fair comparison within the same person.
What is measured: Gum pocket depth, gum attachment level, and gum bleeding - checked at the start of the study and again after 3 months.
The study was conducted at Thumbay University Hospital, UAE
详细描述
Detailed Description Periodontitis is a multifactorial inflammatory disease driven by a dysbiotic subgingival microbiome. Despite non-surgical periodontal therapy (NSPT) being the gold standard, complete bacterial elimination is not always achieved, and residual periodontal pathogens such as Porphyromonas gingivalis and Treponema denticola can persist post-treatment. This has led to the exploration of adjunctive therapies to enhance clinical outcomes.
Antimicrobial photodynamic therapy (aPDT) is a non-antibiotic adjunct that uses a photosensitizing dye activated by laser light of a specific wavelength. Upon activation in the presence of oxygen, the dye generates cytotoxic reactive oxygen species and singlet oxygen, which disrupt bacterial cell membranes and DNA. Indocyanine green (ICG), a near-infrared photosensitizer with peak absorption in the 800-830 nm range, demonstrates high uptake among key periodontal pathogens and carries no risk of inducing antimicrobial resistance.
Study Rationale:
Current systematic reviews on aPDT as an adjunct to NSPT report contradictory findings, often attributed to heterogeneous study designs, mixed periodontitis staging, and short follow-up periods. This study addresses these limitations by focusing exclusively on a well-defined patient population with Stage II periodontitis and employing a split-mouth design to minimize inter-subject variability.
Intervention Protocol:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
he outcomes assessor was masked to treatment allocation during clinical parameter recording. Standardized acrylic stents and a UNC-15 mm periodontal probe were used to ensure consistent and unbiased measurements at baseline and three months.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •- Adults aged 18 years and older
- •Diagnosis of Stage II periodontitis according to the 2018 classification of the World Workshop of Periodontology (AAP/EFP)
- •At least two non-adjacent sites with interproximal probing pocket depth of 4-5 mm
- •Interproximal clinical attachment loss of 3-4 mm at affected sites
- •Willing and able to provide written informed consent
排除标准
- •Periodontal therapy including scaling and root debridement within the last 12 months
- •Antibiotic use or regular use of mouthwash in the 3 months prior to enrollment
- •Pregnancy
- •Any systemic condition that may affect periodontal healing (e.g. uncontrolled diabetes, immunocompromised states)
- •Regular use of hormonal contraceptives
- •Smoking more than 10 cigarettes per day
研究组 & 干预措施
NSPT + Antimicrobial Photodynamic Therapy (Test)
Test sites received full-mouth NSPT followed by adjunctive antimicrobial photodynamic therapy (aPDT). Indocyanine green (ICG) dye was reconstituted at 5 mg/ml and delivered to the base of the periodontal pocket via a 27-gauge needle using a coronal withdrawal technique. The photosensitizer was activated using an Elexxion AG 810 nm diode laser, with the fiber tip moved in an apico-coronal direction parallel to the root surface within the pocket.
干预措施: Antimicrobial Photodynamic Therapy (aPDT) with Indocyanine Green and 810 nm Diode Laser (Device)
NSPT + Antimicrobial Photodynamic Therapy (Test)
Test sites received full-mouth NSPT followed by adjunctive antimicrobial photodynamic therapy (aPDT). Indocyanine green (ICG) dye was reconstituted at 5 mg/ml and delivered to the base of the periodontal pocket via a 27-gauge needle using a coronal withdrawal technique. The photosensitizer was activated using an Elexxion AG 810 nm diode laser, with the fiber tip moved in an apico-coronal direction parallel to the root surface within the pocket.
干预措施: Non-Surgical Periodontal Therapy (NSPT) (Procedure)
NSPT Alone (Control)
Control sites received full-mouth non-surgical periodontal therapy (NSPT) consisting of supragingival and subgingival debridement using an ultrasonic scaler and Gracey curettes (Hu-Friedy, Chicago, IL). Oral hygiene instructions were reinforced at each visit. Pocket depth was standardized using an individualized acrylic resin occlusal stent with a UNC-15 periodontal probe.
干预措施: Non-Surgical Periodontal Therapy (NSPT) (Procedure)