The effectiveness of photodynamic and antibiotic gel therapy as an adjunct to mechanical debridement in the treatment of peri-implantitis among diabetic patients

Paras Ahmed; Ishfaq A Bukhari; Refal Albaijan; Saeed A Sheikh; Fahim Vohra

doi:10.1016/j.pdpdt.2020.102077

The effectiveness of photodynamic and antibiotic gel therapy as an adjunct to mechanical debridement in the treatment of peri-implantitis among diabetic patients

Photodiagnosis Photodyn Ther. 2020 Dec:32:102077. doi: 10.1016/j.pdpdt.2020.102077. Epub 2020 Nov 4.

Authors

Paras Ahmed¹, Ishfaq A Bukhari², Refal Albaijan³, Saeed A Sheikh², Fahim Vohra⁴

Affiliations

¹ Oral Medicine Unit, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
² Department of Pharmacology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
³ Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
⁴ Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia. Electronic address: fvohra@ksu.edu.sa.

PMID: 33157330
DOI: 10.1016/j.pdpdt.2020.102077

Abstract

Aim: The current clinical trial aimed to assess the effectiveness of adjunctive photodynamic therapy (aPDT) and adjunctive antibiotic gel therapy (aAGT) to treat peri-implantitis among patients with type 2 diabetes mellitus (T2DM).

Methods: Selected T2DM participants with peri-implantitis were distributed into 3 groups: Group-1: received a single session of adjunctive (aPDT); Group-2: received a single session of adjunctive (aAGT) (metronidazole 400 mg and amoxicillin 500 mg); and Group-3: received MD alone. Clinical (probing depth [PD], bleeding on probing [BOP], and plaque scores [PS]) and radiographic (crestal bone loss [CBL]) peri-implant variables were recorded. Levels of interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-α) were assessed after the collection of peri-implant sulcular fluid (PISF). All the evaluations were carried out at baseline, 3- and 6-months. The significance level was set to p < 0.05.

Results: At 3-and 6-months of follow-up, all the three groups showed significant alleviation in PS (p < 0.05), BOP (p < 0.05), and PD (p < 0.05) when compared with the baseline. At baseline, no significant variation was observed in all clinical and radiographic peri-implant parameters among all three research groups. At 3-months follow-up, a considerable alleviation of in PS, BOP, PD, and CBL was noticeable in group-1 patients when compared with the baseline. At 6-months follow-up, a comparable difference was observed in BOP, PD, and CBL between group-1 and group-2. At baseline, no significant variation was observed in the PISF levels of IL-6 and TNF-α among all three research groups. At 3- and 6-months follow-up, a considerable alleviation of TNF-α and IL-6 levels was observed in group-1 and group-2 patients, respectively, when compared with the baseline.

Conclusion: The application of aPDT demonstrated improved clinical, radiographic, and immunological peri-implant parameters for the treatment of peri-implantitis among T2DM patients.

Keywords: Antibiotic therapy; Peri-Implantitis; Photodynamic therapy; T2DM;Diabetes.

Publication types

Clinical Trial

MeSH terms

Anti-Bacterial Agents / therapeutic use
Debridement
Dental Implants*
Diabetes Mellitus, Type 2* / complications
Diabetes Mellitus, Type 2* / drug therapy
Humans
Peri-Implantitis* / drug therapy
Photochemotherapy* / methods
Photosensitizing Agents / therapeutic use

Substances

Anti-Bacterial Agents
Dental Implants
Photosensitizing Agents