Evaluación clínica de la terapia fotodinámica como coadyuvante en el tratamiento de la enfermedad periodontal.

Abstract

Introduction: Scaling and root planing (SRP) is the conventional non-surgical treatment for periodontitis and aims to halt the progression of periodontal inflammation. An adjunctive alternative is photodynamic therapy (PDT), which involves activation of a photosensitizer by low-power laser light to selectively destroy periodontopathogenic bacteria. Objective: To evaluate the clinical efficacy of photodynamic therapy as an adjunctive treatment for periodontal disease by comparing clinical improvement parameters with those obtained through conventional SRP in patients diagnosed with periodontitis. Methods: An experimental split-mouth design with intra-individual control was conducted in 30 patients. One hemi-arch received SRP alone, while the contralateral hemi-arch received SRP combined with PDT. Probing pocket depth (PPD) and clinical attachment level (CAL) were assessed per hemi-arch, whereas bleeding on probing (BOP), plaque index (PI), and gingival index (GI) were evaluated at the patient level. The variation (Δ) between baseline and the 30- day post-treatment follow-up was calculated for all parameters. Results: Statistically significant improvements were observed in all clinical parameters (p < 0.05). The hemi-arch treated with SRP + PDT showed greater clinical reductions compared with SRP alone: ΔPPD (SRP + PDT: −1.6 ± 0.8 mm vs SRP: −0.9 ± 0.5 mm) and ΔCAL (−0.6 ± 0.7 mm vs SRP: −0.2 ± 0.4 mm). At the patient level, reductions were also observed for Δ%BOP (−32.5 ± 3.2), Δ%PI (−31.2 ± 12.8), and ΔGI (−1.6 ± 0.5). Conclusion: In patients with periodontitis, photodynamic therapy provides an additional clinical benefit when used as an adjunct to scaling and root planing, improving periodontal parameters at 30 days post-treatment.