Comparative evaluation of local drug delivery using tetracycline fibers and antimicrobial photodynamic therapy in Stage II Grade B periodontitis: A clinico-microbiological study.

Abstract

Background: Periodontal therapy aims to eliminate the periopathogens involved in disease progression to restore the lost form and function of the tooth-supporting structures. To overcome the drawbacks of conventional treatment, several adjunctive treatment modalities have been successfully used to treat moderate-to-severe periodontal diseases. The present study aims to comparatively evaluate the efficacy of locally delivered tetracycline fibers and antimicrobial photodynamic therapy (PDT) as an adjunct to nonsurgical periodontal treatment, focusing on the possibility of improving the clinical parameters and reducing the microbial load postoperatively.

Materials and methods: Twenty-two patients with Stage II Grade B periodontitis were divided into two groups: Group A: scaling and root planing (SRP) + locally delivered tetracycline fibers and Group B: SRP + antimicrobial PDT using indocyanine green as photosensitizer. The following clinical parameters were assessed at baseline, 3 months, and 6 months: Gingival index, modified sulcular bleeding index, clinical attachment level, and probing pocket depth. Subgingival plaque samples were obtained for microbial analysis of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Prevotella intermedia at the following periods.

Results: There was significant improvement in clinical and microbiological parameters in both the groups at 3 months and 6 months postoperatively. Microbial recolonization was noted in both the groups, albeit without reaching statistical significance with respect to P. gingivalis and A. actinomycetemcomitans at 6 months postoperatively.

Conclusion: From the results obtained, it can be concluded that both local drug delivery and antimicrobial PDT can be used as an effective adjunctive treatment to SRP. However, supportive periodontal care is required to avoid microbial recolonization.