Efeito da associação do oxigênio ativo e terapia fotodinâmica no tratamento de bolsas periodontais residuais em pacientes diabéticos tipo 2: estudo clínico controlado randomizado
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Data
2022-08-05
Autores
Cláudio, Marina Módolo [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Objetivo do presente estudo clínico controlado randomizado foi avaliar o efeito do gel de liberação de oxigênio ativo associado ou não à terapia fotodinâmica, no tratamento de bolsas periodontais residuais em pacientes com Diabetes Melito tipo 2 (DM2) e periodontite. Cinquenta e um pacientes diabéticos não compensados com periodontite estágio III e IV grau C em terapia de manutenção foram selecionados e alocados: grupo RAR (n=17) - raspagem e aplainamento radicular (RAR) em uma única sessão; grupo BM (n=17) - RAR em sessão única com aplicação do gel de oxigênio ativo (blue®m) no interior da bolsa periodontal (quantidade de 0,4ml) por 3 minutos, seguido da aspiração do gel; grupo BM+aPDT (n=17) - RAR em sessão única seguida da aplicação local de blue®m durante 3 minutos, aspiração do gel e irrigação da bolsa com azul de metileno (100 µg/ml), e após 1 minuto irradiação com laser de diodo (AlGaInP, 660±10 nm) durante 50 segundos. Parâmetros clínicos peridontais, presença de bolsas residuais e níveis séricos de hemogloblina glicada, análise imunológica e microbiológica foram avaliados. Todos os dados foram submetidos à análise estatística (α=5%). Foi verificada redução de SS aos 90 e 180 dias no grupo BM+aPDT (p<0,05). A porcentagem de sítios com PS ≥ 4mm reduziu aos 90 dias no grupo BM+aPDT e grupo BM, enquanto que aos 180 dias, apenas o grupo BM, apresentou redução (p<0,05). Grupo RAR e BM+aPDT apresentaram redução de bolsas residuais aos 90 e 180 dias, enquanto que o grupo BM, apresentou redução somente aos 90 dias (p<0,05). O grupo BM+aPDT foi capaz de reduzir níveis de TNF-α aos 90 dias. Não foram detectadas diferenças entre os níveis de P. gingivalis e P. intermedia. Conclui-se que o uso do gel de liberação de oxigênio ativo associado ou não a aPDT promoveu benefícios clínicos adicionais no tratamento de bolsas residuais em indivíduos com DM2.
The aim of this randomized controlled clinical study was to evaluate the effect of active oxygen release gel associated or not with photodynamic therapy in the treatment of residual periodontal pockets in patients with Type 2 Diabetes Mellitus (DM2) and periodontitis. Fifty-one diabetic patients not compensated with periodontitis stage III and IV grade C in maintenance therapy were selected and allocated: RAR group (n=17) - root scraping and flattening (RAR) in a single session; group BM (n=17) - RAR in a single session with application of active oxygen gel (blue m®) inside the periodontal pouch (amount of 0.4ml) for 3 minutes, followed by gel aspiration; BM+aPDT group (n=17) - RAR in a single session followed by local application of blue®m for 3 minutes, gel aspiration and irrigation of the bag with methylene blue (100 μg/ml), and after 1 minute diode laser irradiation (AlGaInP, 660±10 nm) for 50 seconds. Peridontal clinical parameters, presence of residual pockets and serum levels of glycated hemogloblin, immunological and microbiological analysis were evaluated. All data were submitted to statistical analysis (α=5%). SS reduction was observed at 90 and 180 days in the BM+aPDT group (p<0.05). The percentage of sites with PS ≥ 4mm decreased at 90 days in the BM+aPDT group and bm group, while at 180 days, only the BM group, showed a reduction (p<0.05). The RAR group and BM+aPDT showed a reduction in residual pockets at 90 and 180 days, while the BM group showed a reduction only at 90 days (p<0.05). The BM+aPDT group was able to reduce TNF-α at 90 days. No differences were detected between the levels of P. gingivalis and P. intermedia. It was concluded that the use of active oxygen release gel associated or not with aPDT promoted additional clinical benefits in the treatment of residual pockets in individuals with DM2.
The aim of this randomized controlled clinical study was to evaluate the effect of active oxygen release gel associated or not with photodynamic therapy in the treatment of residual periodontal pockets in patients with Type 2 Diabetes Mellitus (DM2) and periodontitis. Fifty-one diabetic patients not compensated with periodontitis stage III and IV grade C in maintenance therapy were selected and allocated: RAR group (n=17) - root scraping and flattening (RAR) in a single session; group BM (n=17) - RAR in a single session with application of active oxygen gel (blue m®) inside the periodontal pouch (amount of 0.4ml) for 3 minutes, followed by gel aspiration; BM+aPDT group (n=17) - RAR in a single session followed by local application of blue®m for 3 minutes, gel aspiration and irrigation of the bag with methylene blue (100 μg/ml), and after 1 minute diode laser irradiation (AlGaInP, 660±10 nm) for 50 seconds. Peridontal clinical parameters, presence of residual pockets and serum levels of glycated hemogloblin, immunological and microbiological analysis were evaluated. All data were submitted to statistical analysis (α=5%). SS reduction was observed at 90 and 180 days in the BM+aPDT group (p<0.05). The percentage of sites with PS ≥ 4mm decreased at 90 days in the BM+aPDT group and bm group, while at 180 days, only the BM group, showed a reduction (p<0.05). The RAR group and BM+aPDT showed a reduction in residual pockets at 90 and 180 days, while the BM group showed a reduction only at 90 days (p<0.05). The BM+aPDT group was able to reduce TNF-α at 90 days. No differences were detected between the levels of P. gingivalis and P. intermedia. It was concluded that the use of active oxygen release gel associated or not with aPDT promoted additional clinical benefits in the treatment of residual pockets in individuals with DM2.
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Palavras-chave
Periodontite, Diabetes mellitus, Bolsa periodontal, Fotoquimioterapia, Periodontitis