Clinical and microbiological effects of aPDT compared with systemic amoxicillin/ metronidazole in the treatment of chronic periodontitis in smokers: a randomized controlled study

Abstract

Clinical and microbiological effects of aPDT compared with systemic Amoxicillin/ Metronidazole in the treatment of chronic periodontitis in smokers: a randomized controlled study.The aim of this study will be evaluate the clinical and microbiological effects of scaling and root planing (SRP) combined with Metronidazole and Amoxicillin (MTZ+AMX) or antimicrobial photodynamic therapy (aPDT) in the treatment of smokers with chronic periodontitis. A double-blind controlled, randomized clinical trial will be conducted in 51 patients who will receive: Group SRP (n=17) - scaling and root planning; Group MTZ+AMX (n=17) - SRP combined with Metronidazole (400 mg 3 X per day 7 days) and Amoxicillin (500 mg 3 X per day 7 days); Group aPDT (n=17) - SRP combined with aPDT in pockets e 4 mm (baseline, 48 and 72 hs). Clinical and microbiologic examination will be performed at baseline, 3 and 6 months post-therapy. Clinical parameters of visible plaque index, bleeding on probing, probing depth, gingival recession and clinical attachment level will be measured. Microbiologic subgingival samples will be taken from deepest pockets in group SRP, MTZ+AMX and group aPDT, in pockets e 4 mm treated with aPDT. The aPDT will be performed using a methylene blue and a low level laser therapy after 1 minute (GaAlAs, 660 nm, 100mW, 48 seconds, 157 J/cm2), immediately, 48 and 72 hours pos-treatment. Five periodontal pathogens will be quantified by real time polymerase chain reaction: Porphyromonas gingivalis (Pg), Tannerella forsythensis (Tf), Aggregatibacter actinomycetemcomitans (Aa), Prevotella nigrescens (Pn) and Prevotella intermedia (Pi). The clinical and microbiological data will be statistically analyzed (± = 5%). (AU)