Treatment of chronic periodontitis with multiple episodes of antimicrobial photodynamic therapy (aPDT) or systemic use of amoxicillin and metronidazole: randomized clinical trial

Abstract

The objective of the study is to compare, using clinical, microbiological and immunological analyzes, the effects of the use of systemic antibiotics with multiple applications of antimicrobial photodynamic therapy (aPDT), as adjuncts to the treatment of chronic periodontitis. A controlled randomized clinical trial will be conducted in 34 patients who will receive: AMX / MTZ group (n = 17) - Scaling and Root Planing (SRP) and systemic use of metronidazole (400 mg 3 X a day, 7 days) and amoxicillin (500 3 mg per day X 7 days); APDT group (n = 17) - 3 applications of RAR and APDT in two places (1 moderate and 1 deep probe) per quadrant, immediately, 48 and 72 hours after SRP, and receive two placebo tablets daily for 3 x 7 days. The APDT will be performed using methylene blue and low intensity laser after 1 minute (GaAlAs, 660 nm, 100 mW, 48/2, 157 J/cm2) immediately, 48 and 72 hours after treatment, in the same sites of collection. Clinical, microbiological and immunological tests will be performed at baseline and at 90 days after treatment. The clinical parameters of visible plaque index, bleeding on probing, probing depth, gingival recession and clinical attachment level will be assessed. Samples of subgingival plaque from a probe e 4 d 6 mm (moderate) and a e 7 mm (depth) will be collected in each quadrant of the patient. For microbiological analysis, two periodontal pathogens will be evaluated by Polymerase Chain Reaction in Real Time (Real Time - PCR): Porphyromonas gingivalis (Pg) and Prevotella intermedia (Pi). In immunological analysis will evaluate the presence of prostaglandin E2 (PGE2) using Elisa method. Clinical, microbiological and immunological data will be statistically analyzed (± = 5 %). (AU)