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Abstract：
OBJECTIVE: To assess the short-term efficacy of multiple sessions of antimicrobial photodynamic therapy (aPDT), light-emitting-diode (LED) photobiomodulation, and topical ozone therapy applications following surgical regenerative treatments on clinical parameters, patient-centered outcomes, and mRNA expression levels of VEGF, IL-6, RunX2, Nell-1, and osterix in gingival crevicular fluid samples in patients with stage III/IV, grade C periodontitis.
METHODS: Forty-eight systemically healthy patients were assigned into four groups to receive adjunctive modalities with regenerative periodontal surgical treatment. A 970 ± 15 nm diode laser plus indocyanine-green for aPDT group, a 626 nm LED for photobiomodulation group, and topical gaseous ozone were applied at 0, 1, 3, and 7 postoperative days and compared to control group. The clinical periodontal parameters, early wound healing index (EHI), and postoperative patients\' morbidity were evaluated. The mRNA levels of biomarkers were assessed by real-time polymerase chain reaction.
RESULTS: No significant difference in the clinical parameters except gingival recession (GR) was identified among the groups. For group-by-time interactions, plaque index (PI) and probing pocket depths (PD) showed significant differences (p = 0.034; p = 0.022). In sites with initial PD > 7 mm, significant differences were observed between control and photobiomodulation groups in PD (p = 0.011), between control and aPDT, and control and photobiomodulation groups in CAL at 6-month follow-up (p = 0.007; p = 0.022). The relative osterix mRNA levels showed a statistically significant difference among the treatment groups (p = 0.014).
CONCLUSIONS: The additional applications of aPDT and LED after regenerative treatment of stage III/IV grade C periodontitis exhibited a more pronounced beneficial effect on clinical outcomes in deep periodontal pockets.
METHODS: Forty-eight systemically healthy patients were assigned into four groups to receive adjunctive modalities with regenerative periodontal surgical treatment. A 970 ± 15 nm diode laser plus indocyanine-green for aPDT group, a 626 nm LED for photobiomodulation group, and topical gaseous ozone were applied at 0, 1, 3, and 7 postoperative days and compared to control group. The clinical periodontal parameters, early wound healing index (EHI), and postoperative patients\' morbidity were evaluated. The mRNA levels of biomarkers were assessed by real-time polymerase chain reaction.
RESULTS: No significant difference in the clinical parameters except gingival recession (GR) was identified among the groups. For group-by-time interactions, plaque index (PI) and probing pocket depths (PD) showed significant differences (p = 0.034; p = 0.022). In sites with initial PD > 7 mm, significant differences were observed between control and photobiomodulation groups in PD (p = 0.011), between control and aPDT, and control and photobiomodulation groups in CAL at 6-month follow-up (p = 0.007; p = 0.022). The relative osterix mRNA levels showed a statistically significant difference among the treatment groups (p = 0.014).
CONCLUSIONS: The additional applications of aPDT and LED after regenerative treatment of stage III/IV grade C periodontitis exhibited a more pronounced beneficial effect on clinical outcomes in deep periodontal pockets.
摘要：
目的：评估多次抗菌光动力疗法（aPDT）的短期疗效，发光二极管（LED）光生物调节，和局部臭氧治疗应用后的外科再生治疗的临床参数，以患者为中心的结果，和VEGF的mRNA表达水平，III/IV期患者龈沟液样本中的IL-6，RunX2，Nell-1和osterix，C级牙周炎.
方法：将48例全身健康的患者分为4组，接受再生牙周辅助手术治疗。aPDT组的970±15nm二极管激光器加吲哚菁绿，用于光生物调节组的626nmLED，术后第0、1、3和7天局部应用气态臭氧，并与对照组进行比较。临床牙周参数，早期伤口愈合指数（EHI），和术后患者的发病率进行评估。通过实时聚合酶链反应评估生物标志物的mRNA水平。
结果：除牙龈退缩（GR）外，各组间临床参数无显著差异。对于按时间分组的交互，菌斑指数（PI）和探查袋深度（PD）显示显着差异（p=0.034；p=0.022）。在初始PD>7mm的部位，在PD的对照组和光生物调节组之间观察到显着差异（p=0.011），在控制和aPDT之间，在6个月的随访中，CAL的对照组和光生物调节组（p=0.007；p=0.022）。相对osterixmRNA水平在治疗组之间显示出统计学上的显着差异（p=0.014）。
结论：在III/IV级C级牙周炎再生治疗后，aPDT和LED的额外应用对深牙周袋的临床结局表现出更显著的有益效果。
方法：将48例全身健康的患者分为4组，接受再生牙周辅助手术治疗。aPDT组的970±15nm二极管激光器加吲哚菁绿，用于光生物调节组的626nmLED，术后第0、1、3和7天局部应用气态臭氧，并与对照组进行比较。临床牙周参数，早期伤口愈合指数（EHI），和术后患者的发病率进行评估。通过实时聚合酶链反应评估生物标志物的mRNA水平。
结果：除牙龈退缩（GR）外，各组间临床参数无显著差异。对于按时间分组的交互，菌斑指数（PI）和探查袋深度（PD）显示显着差异（p=0.034；p=0.022）。在初始PD>7mm的部位，在PD的对照组和光生物调节组之间观察到显着差异（p=0.011），在控制和aPDT之间，在6个月的随访中，CAL的对照组和光生物调节组（p=0.007；p=0.022）。相对osterixmRNA水平在治疗组之间显示出统计学上的显着差异（p=0.014）。
结论：在III/IV级C级牙周炎再生治疗后，aPDT和LED的额外应用对深牙周袋的临床结局表现出更显著的有益效果。
