Clinical periodontal, bacterial, and immunological outcomes of antimicrobial photodynamic therapy in orthodontic treatment-induced gingival enlargement.

AIM: The aim of the present clinical trial is to evaluate the clinical, bacterial, and immunological outcomes of photodynamic therapy (PDT) in adolescent patients with orthodontic treatment-induced gingival enlargement (OTGE). MATERIALS AND METHODS: A total of 26 adolescent patients, 16 girls and 10 boys, of mean age 16.8 years, undergoing fixed orthodontic treatment for at least 6 months (mean duration in months, 8.3 ± 1.9) and presenting with GE were included in the clinical trial. All patients undergoing fixed orthodontic treatment with clinical diagnosis of OTGE were divided into two groups: Patients receiving full-mouth periodontal debridement (FMPD) 'Group-FMPD' and 'Group-PDT' included participants receiving methylene blue-assisted PDT in the selected area along with FMPD. Clinical periodontal assessments included the evaluation of plaque scores (PS), bleeding on probing (BOP), probing depth (PD) and hyperplastic index (HI). The total bacterial counts of Porphyromonas gingivalis (P. gingivalis), Treponema denticola (T. denticola), and Tannerella forsythia (T. forsythia) were estimated and expressed as log CFU/mL of each bacteria. Cytokines including interleukin (IL)-1ß and IL-6 were analyzed using enzyme-linked immunosorbent assay (ELISA) kit. RESULTS: The mean percentage of PS and BOP statistically significantly reduced with both FMPD and PDT from baseline to 4 weeks (p < 0.05). Although mean PD significantly reduced in both the groups at all time points, there was significantly higher reduction with PDT as compared to FMPD at 2 weeks post treatment (p < 0.05). Inter-group comparison showed PDT demonstrated significantly higher HI at 2- and 4-weeks post treatment (p < 0.05). The mean log CFU/mL of P. gingivalis and T. forsythia showed statistically significantly higher reduction with PDT than FMPD (p < 0.05) at both 2-and 4-weeks follow-up. T. denticola reported significantly reduced levels at 2 weeks follow-up period only with PDT (p < 0.05). No statistically significant difference appeared when both treatment modalities were compared with one another (p > 0.05). Four weeks after periodontal treatment, IL-6 significantly reduced with PDT compared to FMPD (p < 0.05). CONCLUSION: PDT assisted in reducing bacterial counts and improving hyperplastic index in OTGE.