Clinical evaluation of photobiomodulation therapy and local 1.2% atorvastatin gel as an adjunct to subgingival instrumentation in patients with stage II periodontitis: a randomized controlled trial.

Abstract

Objective: The aim of the present study was to compare the effectiveness of photobiomodulation therapy versus local 1.2% atorvastatin gel as an adjunct to subgingival instrumentation in the treatment of stage II or III periodontitis.

Method and materials: In this randomized study, a total of 60 individuals with pocket depths of 4 to 7 mm bilaterally in both sexes (men and women) who were 25 years old or older, diagnosed with stage II or III periodontitis were selected. In total, 60 patients with at least four teeth demonstrating pocket depth of ≥ 4 to 7 mm were selected. Exclusion criteria included patients with systemic conditions, smokers, pregnant or lactating women, and those who had received periodontal therapy or antibiotics within the previous 6 months. Baseline clinical parameters including full-mouth plaque scores, full-mouth bleeding scores, probing pocket depth, and clinical attachment level were recorded. All the eligible patients underwent supra- and subgingival instrumentation. The patients were then randomly divided into two groups. Group A: 30 patients (120 pocket sites) received photobiomodulation therapy with 680 nm for 60 sec (6 J/cm2) with 0.1 W power. Group B: 30 patients (120 pocket sites) received 1.2% atorvastatin gel as local drug delivery. After application of the local drug, the treated periodontal pockets were secured with N-butyl-2-cyanoacrylate. Patients were recalled at baseline and after 1 month and 3 months, and clinical periodontal parameters were recorded.

Results: On intergroup comparison, there were notable improvements in all clinical parameters at the 3-month interval after subgingival instrumentation in combination with photobiomodulation or local drug delivery. In the intragroup comparison, at the 3-month interval, the reduction in probing depth and clinical attachment gain were more significantly evident in group B (1.2% atorvastatin gel) compared to Group A (photobiomodulation). These findings are consistent with the available literature, which recognizes subgingival instrumentation as an effective nonsurgical therapy for periodontitis. Adjunctive treatment modalities are widely investigated to determine whether they can further enhance the clinical outcomes achieved by subgingival instrumentation.

Conclusion: The principal results of this study showed improved periodontal status and significant improvements in clinical parameters in patients in Group B (1.2% atorvastatin gel). Within the limitations of the study, it was concluded that both photobiomodulation and 1.2% atorvastatin gel can be effectively used as adjuncts to subgingival instrumentation in the treatment of periodontitis.