Antimicrobial photodynamic therapy vs. local minocycline in addition to non-surgical therapy of deep periodontal pockets: a controlled randomized clinical trial

Objectives: To investigate the additional influence of either antimicrobial photodynamic therapy (aPDT; Helbo® Photodynamic Systems) or local application of minocycline microspheres (MC; Arestin, OraPharma) on clinical and microbiological healing results in deep periodontal pockets (PPD ≥6 mm) following non-surgical periodontal therapy (SRP).

Materials and methods: Forty-five patients with chronic periodontitis were evaluated: test group aPDT + SRP (n = 15), positive control group MC + SRP (n = 15), and negative control group SRP-alone (n = 15). Clinical and microbiological healing parameters were recorded in every patient for four experimental teeth at baseline, 6 weeks, and 3, 6, and 12 months. Wilcoxon signed-rank test and Mann-Whitney U test were used for statistical analysis (α = 0.05).

Results: Significant improvements in clinical and microbiological parameters were found for all groups after 6 weeks and 3, 6, and 12 months. Differences between groups were not statistically significant. Changes after 12 months [median (25/75%)] are as follows: reduction in PPD [mm]: aPDT + SRP 2 (1/3), MC + SRP 3 (1/4), SRP-alone 2 (1/3); percentage of residual BOP positive teeth [%]: aPDT + SRP 75 (25/100), MC + SRP 33.3 (0/50), SRP-alone 66.7 (25/75).

Conclusions: Within the limitations of this study, neither the applied aPDT system nor MC showed a significant additional influence on clinical and microbiological healing outcomes in deep periodontal pockets compared to SRP alone.

Clinical relevance: In deep periodontal defects, the efficacy of non-surgical periodontal treatment seems not to be improved by adjunctive use of antimicrobial photodynamic therapy or minocycline microspheres.