Efeito de diferentes terapias locais para o tratamento de periodontite crônica em indivíduos diabéticos tipo 2: estudo clínico controlado randomizado triplo cego de boca dividida com acompanhamento de seis meses
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Data
2016-01-06
Autores
Santos, Nídia Cristina Castro dos [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
O objetivo do estudo foi comparar diferentes abordagens para o tratamento da periodontite crônica em pacientes portadores de diabetes mellitus tipo 2 (DM2). Em 20 pacientes portadores de diabetes mellitus tipo 2 com periodontite crônica generalizada moderada a avançada foram selecionadas 3 bolsas periodontais com profundidade de sondagem e perda de inserção ≥5mm que receberam debridamento ultrassônico (DU) somente (Grupo Controle), DU associado à Terapia Fotodinâmica antimicrobiana (Grupo PDT) e DU associado à Terapia com Laser de Baixa Intensidade (Grupo LLLT). As medidas clínicas avaliadas, como Profundidade de Sondagem (PS), Nível Clínico de Inserção (NIC), Recessão Gengival (RG), Sangramento à Sondagem (SS), Índice Gengival (IG) e Índice de Placa (IP), foram coletadas e comparadas no baseline (BL), 30, 90 e 180 dias. Houve redução estatisticamente significante do BL para 180 dias na PS de 5,75±0,91mm para 3,47±0,97mm no Grupo Controle, de 6,15±1,27mm para 3,71±1,63mm no Grupo PDT e de 6,50±1,61mm para 4,16±1,78mm no Grupo LLLT. Porém a diferença entre os grupos não foi significante. Em RG, o Grupo LLLT apresentou diferença estatisticamente significante em relação aos demais grupos. Pode-se concluir que a aplicação adicional de LLLT mostrou melhores resultados em RG do que as demais terapias. As aplicações adjuntas de PDT e LLLT ao DU não apresentaram benefícios adicionais na redução de PS e no ganho de NIC, sendo as três terapias eficientes no tratamento da periodontite crônica em diabéticos tipo 2.
The aim of this study was to compare the local effect of different approaches for the treatment of moderate to severe generalized chronic periodontitis in type 2 diabetic patients. Twenty type 2 diabetic patients with moderate to severe generalized chronic periodontitis were selected. Three periodontal pockets with Probing Depth and Attachment Loss ≥ 5mm received ultrasonic debridement (UD) only (Control Group), UD with adjunct antimicrobial Photodynamic Therapy (PDT Group), or UD with Low Level Laser Therapy (LLLT Group). Clinical measures, such as Probing Depth (PD), Clinical Attachment Level (CAL), Gingival Recession (GR), Bleeding on Probing (BP), Gingival Bleeding Index (GBI), and Plaque Index (PI), were collected and compared at baseline, 30, 90, and 180 days. After 180 follow-up days there was statistically significant reduction in PD from 5.75±0.91mm to 3.47±0.97mm in Control Group, from 6.15±1.27mm to 3.71±1.63mm in PDT Group, and from 6.50±1.61mm to 4.16±1.78mm in LLLT Group. However, intergroup analysis did not reveal any statistically significant difference (p>0.05). For GR, intergroup analysis presented statistically significant difference for LLLT Group. It can be concluded that additional LLLT application showed better results for GR then the other therapies. The adjunct application of PDT and LLLT to UD had no additional benefits for PD reduction and CAL gain, meaning that all the investigated therapies are efficient for the treatment of chronic periodontitis in type 2 diabetics.
The aim of this study was to compare the local effect of different approaches for the treatment of moderate to severe generalized chronic periodontitis in type 2 diabetic patients. Twenty type 2 diabetic patients with moderate to severe generalized chronic periodontitis were selected. Three periodontal pockets with Probing Depth and Attachment Loss ≥ 5mm received ultrasonic debridement (UD) only (Control Group), UD with adjunct antimicrobial Photodynamic Therapy (PDT Group), or UD with Low Level Laser Therapy (LLLT Group). Clinical measures, such as Probing Depth (PD), Clinical Attachment Level (CAL), Gingival Recession (GR), Bleeding on Probing (BP), Gingival Bleeding Index (GBI), and Plaque Index (PI), were collected and compared at baseline, 30, 90, and 180 days. After 180 follow-up days there was statistically significant reduction in PD from 5.75±0.91mm to 3.47±0.97mm in Control Group, from 6.15±1.27mm to 3.71±1.63mm in PDT Group, and from 6.50±1.61mm to 4.16±1.78mm in LLLT Group. However, intergroup analysis did not reveal any statistically significant difference (p>0.05). For GR, intergroup analysis presented statistically significant difference for LLLT Group. It can be concluded that additional LLLT application showed better results for GR then the other therapies. The adjunct application of PDT and LLLT to UD had no additional benefits for PD reduction and CAL gain, meaning that all the investigated therapies are efficient for the treatment of chronic periodontitis in type 2 diabetics.
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Palavras-chave
Diabetes mellitus, Periodontite crônica, Terapia com laser de baixa intensidade, Anti-infecciosos, Diabetes mellitus, Chronic periodontitis, Periodontal debridement, Low-level Laser therapy, Anti-infective agents