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Light-activated disinfection using a light-emitting diode lamp in the red spectrum: clinical and microbiological short-term findings on periodontitis patients in maintenance. A randomized controlled split-mouth clinical trial

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Abstract

Eradication or suppression of pathogens is a major goal in periodontal therapy. Due to the increase in antibiotic resistance, the need of new disinfection therapies is raising. Photodynamic therapy (PDT) has demonstrated anti-infective potential. No data are available on the use of light-emitting diode (LED) lights as the light source in PDT. The aim of this study was to investigate the microbiological and clinical adjunctive outcome of a new photodynamic LED device, compared to scaling and root planing in periodontitis patients in maintenance [supportive periodontal therapy (SPT)]. In this masked, split-mouth design study, 30 treated chronic periodontitis subjects (mean age, 46.2 years; 13 males) in SPT were included. Two residual interdental sites with probing pocket depth (PPD) ≥ 5 mm in two opposite quadrants, with positive bleeding on probing (BOP) and comparable periodontal breakdown, were selected. PPD, BOP and subgingival microbiological samples for real-time PCR analysis (Carpegen® PerioDiagnostics, Carpegen GmbH, Münster, Germany) were recorded at baseline and 1 week after treatment. Scaling and root planing was performed under local anesthesia. Randomly one of the sites was selected to receive adjunctive photodynamic therapy by inserting a photosensitizer (toluidine blue O solution) and exposing it to a LED light in the red spectrum (Fotosan®, CMS Dental, Copenhagen, Denmark), according to the manufacturer’s instructions. After 1 week, 73 % of the control sites and 27 % of the test sites were still BOP+. These differences compared to baseline values and in-between groups were statistically significantly different (p < 0.001). Mean PPD decreased from 5.47 mm (±0.68) to 4.73 mm (±0.74, p < 0.001) in control sites and from 5.63 mm (±0.85) to 4.43 mm (±1.25, p < 0.001, test vs control p = 0.01) in the test group. Microbiologically, higher reductions of relative proportions of red complex bacteria were observed in test sites (68.1 vs. 4.1 %; p = 0.01). This study showed that adjunctive photodynamic treatment by LED light may enhance short-term clinical and microbiological outcome in periodontitis subjects in SPT.

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Conflict of interest

All authors declare that they have no financial relationships related to any products involved in this study and that there are no conflicts of interest in this study.

Funding source

This study was partially supported by CMS Dental (Copenhagen, Denmark) by a grant and by supplying materials used in this study for free.

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Authors and Affiliations

  1. Department of Dental Sciences and Maxillo-Facial Surgery, Section of Periodontics, University of Rome “Sapienza”, Via Caserta 6, 00161, Rome, Italy

    Claudio Mongardini & Andrea Pilloni

  2. Department of Public Health and Infectious Diseases, University of Rome “Sapienza”, Rome, Italy

    Gian Luca Di Tanna

Authors
  1. Claudio Mongardini
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  2. Gian Luca Di Tanna
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  3. Andrea Pilloni
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Corresponding author

Correspondence to Claudio Mongardini.

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Key findings

Although further studies are needed, photodynamic therapy, applying a LED light as the light source, is an easy to use anti-infective therapy for the daily practice in the periodontal clinic, without the problems raised by antibiotic treatments and with less initial costs compared to laser lights.

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Mongardini, C., Di Tanna, G.L. & Pilloni, A. Light-activated disinfection using a light-emitting diode lamp in the red spectrum: clinical and microbiological short-term findings on periodontitis patients in maintenance. A randomized controlled split-mouth clinical trial. Lasers Med Sci 29, 1–8 (2014). https://doi.org/10.1007/s10103-012-1225-x

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  • DOI: https://doi.org/10.1007/s10103-012-1225-x

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