Search

Background/Aim. Treatment of periodontitis undergoes several treatment phases. Non-surgical periodontal treatment (NSPT) represents the basic treatment stage, and it is applied to all the patients undergoing periodontal treatment. Adjunctive antimicrobial photodynamic therapy (aPDT) is one of several contemporary and relatively new possibilities with a role to inactivate microorganisms responsible for the occurrence and progression of the disease. The aim of this study was to comparatively analyze the clinical and microbiological effects of the NSPT alone, as well as combined with aPDT. Methods. A split-mouth method design was used in a prospective randomized controlled trial. The following clinical parameters were registered and monitored: plaque index (PI), bleeding on probing, probing depth (PD), and clinical attachment level (CAL). The presence of microorganisms Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Treponema denticola was detected by the polymerase chain reaction (PCR) method. Samples were tested before the therapy, as well as three months after the therapy. Therapeutic modalities of NSPT and NSPT with adjunct aPDT were examined. Results. All of the analyzed clinical parameters proved statistically significant improvement after the application of both treatment modalities (p < 0.001). Microbiological analyses showed that the total number of microorganisms was statistically significantly lower after the application of both methods (p < 0.001). Following the treatment, there was a statistically significantly reduced number of microorganisms Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Treponema denticola (p < 0.001). NSPT combined with aPDT led to a statistically significant improvement of both clinical parameters and microbiological status compared to NSPT applied on its own. Conclusion. The study showed improvement of all clinical indicators after the application of both treatment modalities. The total number of microorganisms was reduced as well as the number of specific microorganisms. Combining aPDT with NSPT led to a statistically significantly higher reduction in the number of microorganisms compared to NSPT alone.

Background: Periodontitis is a common bacterial infection precipitated by exaggerated host responses to the oral microorganisms, As the first cells to encounter the oral pathogens the gingival epithelial cells (GEC) respond via toll-like receptors (TLR) that recognize conserved microbial patterns. Here we investigated the expression of TLR-2 and TLR-4 in GEC of naοve mice in response to infection with the periodontal pathogen Aggregatibacter actinomycetemcomitans (Aa) . Methods: 7-9 weeks old mice were induced experimental periodontitis by inoculating the palatal gingival with 1x109 colony forming units of Aa. Mice were sacrificed 50 days later and intact maxilla harvested. The degree of alveolar bone loss was determined by micro-CT. Single suspensions of the epithelial cells isolated from palatal gingival tissues were assessed for the expressions of TLR-2 and TLR-4 proteins by flow cytometry and for TLR-2 and TLR-4 mRNA by reverse transcriptase PCR. Differences between the control and the disease groups were determined by students't- test. Results: Both TLR-2 and TLR-4 proteins were significantly elevated in the GEC of mice infected with A . actinomycetemcomitans when compared to the control group. The ratio of TLR-4 to TLR-2 mRNA was upregulated in chornic periodontitis as compared with the control group. Conclusion: Our data suggest that TLR-2 and TLR-4 are regulated differentially in A. actinomycetemcomitans-induced periodontitis.