Evaluation of the local effect of nonsurgical periodontal treatment with and without systemic antibiotic and photodynamic therapy in generalized aggressive periodontitis. A randomized clinical trial.

BACKGROUND: This study's aim was to evaluate the local effect of clarithromycin associated with antimicrobial photodynamic therapy (aPDT) in the treatment of generalized aggressive periodontitis.

MATERIALS AND METHODS: The study sample comprised 72 periodontal pockets on single-rooted teeth in multiple quadrants, with both probing depth and clinical attachment level ≥ 5 mm, and with bleeding on probing. The pockets were randomly distributed into four groups (n = 18 each) that received ultrasonic periodontal debridement in addition to placebo (the UPD group), systemic clarithromycin (the UPD + CLM group), aPDT (the UPD + aPDT group), or both systemic clarithromycin and aPDT (the UPD + CLM + aPDT group). The measurements were performed prior to treatment (baseline) and at 3 and 6 months postoperatively. The following parameters were evaluated: plaque index, bleeding on probing, probing depth, gingival recession, and clinical attachment level. A 5% significance level was used in the statistical analysis.

RESULTS: At 3 months, UPD + aPDT, UPD + CLM, and UPD + CLM + aPDT groups all exhibited reduced probing depths relative to the UPD group (p <  0.05). However, at 6 months, the reduction in mean probing depth was greater in the antibiotic groups (UPD+CLM and UPD+CLM+aPDT) than in the UPD and UPD+aPDT groups (p <  0.05). Regarding clinical attachment level, only the UPD+CLM+aPDT group presented a significant gain relative to the UPD and UPD + PDT groups (p <  0.05).

CONCLUSIONS: Ultrasonic periodontal debridement has greater clinical advantages when associated with clarithromycin than with associated with aPDT. However, the joint application of aPDT and clarithromycin did not present additional benefits.