Efficacy of antimicrobial photodynamic therapy with chloro-aluminum phthalocyanine on periodontal clinical parameters and salivary GSH and MDA levels in patients with periodontitis.

The purpose of this study was to evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) with chloro-aluminum phthalocyanine (AlClPc) on several periodontal parameters includingsalivary glutathione (GSH) and MDA (malondialdehyde) levels in periodontal sites presenting with periodontitis. Randomized clinical trial, comprising 40 test group (TG) sites and 23 control group (CG) sites. The TG was treated with scaling and root planning (SRP) and aPDT, and CG, only with SRP. Visible plaque index [VPI], gingival bleeding index [GBI], bleeding on probing [BOP], probing depth [PD] and clinical attachment level [CAL] were calculated and saliva samples were taken at baseline (T0), three (T3) and six months (T6). Data was analyzed by the Wilcoxon and Mann-Whitney tests. An intragroup analysis indicated significant differences at T3 and T6 for GBI, CAL and GSH only in the CG (p < 0.05). For BOP, a significant decrease was observed only in the TG between T0 and T6 (p = 0.008). No significant differences were observed for VPI, BOP and MDA. In the intergroup analysis, significant differences were observed for GBI at T6 (p = 0.041), and for GSH at T3 (p = 0.031), being higher in the TG. Although aPDT with AlClPc did not present statistically proven benefits, but the employed periodontal treatment resulted in decreased BOP, PD, CAL and MDA after 3 and 6 months of treatment. In addition, the lower need for glutathione production may initially suggest an additional benefit of AlClPc aPDT in the early reestablishment of the balance between oxidative and non-oxidative agents related to oxidative stress.

Antimicrobial Photodynamic Therapy Using a Chloro-Aluminum Phthalocyanine Adjuvant to Nonsurgical Periodontal Treatment Does Not Improve Clinical Parameters in Patients with Chronic Periodontitis.

Background and objective: To evaluate the effects of antimicrobial photodynamic therapy (aPDT) with chloro-aluminum phthalocyanine (AlClFc) adjuvant to scaling and root planing (SRP) on periodontal clinical parameters of patients with chronic periodontitis. Materials and methods: Fifty-four periodontal sites were randomly distributed into two groups: 27 in the test group (SRP+aPDT)-using a low-power laser application Photon Lase III (DMC Equipamentos Ltda, São Carlos, São Paulo, Brazil) with operational parameters of 660 nm and 100 mW for 15 sec, and 27 in the control group (SRP). SRP was performed in a single session and the periodontal clinical parameters such as visible plaque index, bleeding on probing (BOP), probing depth (PD), and clinical attachment level were assessed at the baseline (T0) and 3 months after aPDT (T3). Results: Regarding BOP, a decrease in both treatment groups, the test group (p = 0.003) and control group (p = 0.001), was reported between T0 and T3. A reduction in PD and clinical insertion gain for both treatment groups (p < 0.05) after 3 months of therapy was observed, although nonsignificant (p > 0.05) in intergroup comparison. Conclusions: aPDT with AlClFc adjuvant to SRP did not provide additional benefits in reducing PD and clinical insertion gain.

Antibacterial effectiveness in vitro of different formulations of calcium hydroxide paste / Eficácia antibacteriana in vitro de diferentes formulações de pastas de hidróxido de cálcio

ABSTRACT Objective: To evaluate the antibacterial activity of four formulations of calcium hydroxide paste against microorganisms commonly found in infected root canals. Methods: To evaluate antibacterial activity through the agar diffusion method, pastes of calcium hydroxide were made from its pro-analysis form, diffused into four separate vehicles: distilled water, camphorated p-monochlorophenol, propylene glycol and Otosporin®, testing the antimicrobial activity of these on strains of Staphylococcus aureus, Bacillus subtilis and Enterococcus faecalis. After the incubation period, the presence or otherwise of inhibition zones were observed and their sizes in three stages: 24h, 48h and 72h. With this data, the median between the four dishes was obtained and the consequent value was submitted to Kruskal-Wallis nonparametric statistical analysis, with post-tests of Mann-Whitney and Bonferroni correction, at a significance level of 5%. Results: Only pastes with camphorated p-monochlorophenol and Otosporin vehicles caused the formation of significant inhibition zones, with medians of 8.0 mm. Against the strains of Enterococcus faecalis, only pastes with the camphorated p-monochlorophenol vehicle resulted in the formation of significant inhibition zones, with a median of 3.0 mm. Conclusion : Otosporin and CMCP vehicles provide greater antimicrobial potential to calcium hydroxide against the studied bacteria. However, only the Ca(OH)2 and CMCP combination was effective against all the strains, and can thus be regarded as the paste formulation with the greatest antimicrobial effectiveness in this study.

RESUMO Objetivo: Avaliar a ação antibacteriana de quatro formulações de pastas de hidróxido de cálcio contra microrganismos comumente encontrados em canais radiculares infectados. Métodos: Para avaliar a ação antibacteriana, através do método de difusão em ágar, foram preparadas pastas de hidróxido de cálcio a partir de sua forma pró-análise dispersa em quatro veículos distintos: água destilada, paramonoclorofenol canforado, propilenoglicol e Otosporin®, testando o potencial antibacteriano destas sobre cepas de Staphylococcus aureus, Bacillus subtilis e Enterococcus faecalis. Após o período de incubação, foi verificada a pre¬sença ou não de halos de inibição e seus respectivos tamanhos em três momentos: 24h, 48h e 72h. Com os dados, foi obtida uma mediana das quatro placas e o valor encontra¬do submetido à análise estatística não paramé¬trica Kruskall-Wallis, com pós-testes de Mann-Whitney e penalização de Bonferroni, ao nível de significância de 5%. Resultados: Apenas nas pastas com veículos paramonoclorofenol canforado e Otosporin foi observado a formação de halos de inibição significativos, com medianas de 8,0mm. Sobre as cepas de Enterococcus faecalis, somente a pasta com veículo paramonoclorofenol canforado foi observado formação de halo de inibição significativo, com mediana de 3,0mm. Conclusão: Os veículos Otosporin e PMCC possibilitam maior potencial antimicrobiano ao hidróxido de cálcio frente às bactérias estudadas. No entanto, somente a associação Ca(OH)2 e PMCC foi efetiva contra todas as cepas, e assim pode ser considerada como a formulação de pasta de maior efetividade antimicrobiana neste estudo.