Repeated application of adjunctive photodynamic and antibiotic therapy as an adjunct to root surface debridement in patients with grade C and stage III or IV aggressive periodontitis

Abstract Purpose To evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) and antimicrobial therapy on clinical and immunological outcomes of periodontal treatment in patients with periodontitis grade C and stage III or IV. Material and method The patients recruited in the current research fulfil the clinical case definition of periodontitis ‘grade C’ in terms of onset of the infection and stage III or IV that defines degree and severity of the disease. One-stage full-mouth ultrasonic debridement (UD) was performed and randomly divided in two groups: Group-I – four applications of aPDT, and Group-II – combination of metronidazole (MTZ) and amoxicillin (AMX) 3 tablets each for 7 days. Whole-mouth periodontal parameters were recorded at baseline, 3-, 6-months after completion of treatment. Gingival crevicular fluid samples were obtained for assessment of inflammatory interleukin (IL)-10 and IL-17 at the same time points. Results Seventeen healthy patients completed the study protocol and revealed similar clinical findings at baseline. Bleeding scores significantly reduced in group-I at 3 months post treatment (p   0.05). Conclusion Antimicrobial photodynamic therapy improved severe deep periodontal pockets. However, the combination of antimicrobial therapy helped in reducing proinflammation in grade C and stage III or IV periodontitis.