Adjunctive methylene blue-based antimicrobial photodynamic therapy in the re-instrumentation of residual periodontal pockets in individuals with down syndrome: A randomized controlled clinical trial.

OBJECTIVE

The aim of this study was to evaluate the use of a single session antimicrobial photodynamic therapy (aPDT) protocol in the re-instrumentation of residual periodontal pockets in individuals with Down Syndrome (DS).

METHODS

30 individuals with DS and stages I-III grade B periodontitis were allocated into the following groups: SI (n = 17): subgingival instrumentation (SI) in a single session; SI+aPDT (n = 17): SI in single session in residual pockets with probing depth (PD) ≥4 mm and bleeding on probing (BoP), methylene blue irrigation (100 µg/ml) after 60 s, and diode laser irradiation at 100 mW for 50 s. Periodontal clinical parameters PD, BoP, clinical attachment level (CAL) and immunological analysis interleukin (IL)-17, IL-1B, IL-6, IL-8 were evaluated at baseline and on 60 and 90 days. The clinical procedures performed in this study correspond to step 3 periodontal therapy, targeting residual periodontal pockets. All data were submitted to statistical analysis (α=5 %).

RESULTS

A reduction in BoP was observed at 60 and 90 days in the SI+ aPDT group and in the SI group at 90 days. In the SI group, there was a significant reduction in the percentage of PD 4-5 mm at 90 days. Both groups showed a significant reduction in IL-17 levels on 60 and 90 days. The intergroup comparison has revealed no statistically significant differences.

CONCLUSION

The use of single session aPDT protocol by methylene blue as an adjuvant to non-surgical periodontal treatment in residual periodontal pockets does not promote additional clinical benefits in individuals with DS and periodontitis.

CLINICAL SIGNIFICANCE: The use of aPDT protocol with methylene blue in the re-instrumentation of residual periodontal pockets does not provide significant clinical advantages in individuals with stage I-III periodontitis and DS. These findings suggest that single-session aPDT may not enhance clinical or immunological outcomes beyond those achieved by conventional subgingival instrumentation alone during the step 3 of periodontal therapy.