Impact of Photodynamic Therapy as an Adjunct to Non-surgical Periodontal Treatment on Clinical and Biochemical Parameters Among Patients Having Mild Rheumatoid Arthritis With Periodontitis
Condition: Rheumatoid Arthritis; Chronic Periodontitis
MeSH terms: Arthritis; Arthritis, Rheumatoid; Periodontitis; Chronic Periodontitis
Study type: Interventional

Summary: 
      Purpose: To evaluate the efficacy of photodynamic therapy (PDT) as an adjunct to non-surgical
      periodontal therapy on the clinical periodontal and biochemical parameters among patients
      with rheumatoid arthritis (RA) having periodontitis.

      Methods: A total of 50 RA patients with periodontitis were included. The subjects were
      equally divided into two groups: Group A - scaling and root planning (SRP) + PDT; Group B -
      SRP only, respectively. Plaque score (PS), bleeding on probing (BOP), pocket depth (PD) and
      clinical attachment level (CAL) were estimated. The biochemical parameters included the
      assessment of interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α) and rheumatoid
      factors (RFs). Multiple comparisons were established by employing the Bonferroni's post-hoc
      test for both clinical and laboratory biomarker data. The Mann-Whitney test was used to
      compute the p-value for intergroup comparisons. For intra-group comparisons, the p-value was
      computed with the help of Wilcoxon signed ranks test.
    


Intervention name(s): Methylene blue mediated Photodynamic therapy; Non-surgical periodontal therapy
Intervention type(s): Device; Procedure
Intervention description(s): Methylene blue (MB) with a concentration of 10 mg/mL was delivered inside the periodontal pocket. MB was injected inside in the selected periodontal pockets 4 - 6 mm with the help of a blunt needle and left for 1 min. Later, the periodontal pockets were flushed with distilled water for 3 min to remove the excess MB. The diode laser HELBO® TheraLite - Bredent Medical, Germany) of diameter 200 µm was used to deliver the light to initiate the disinfection process. Each participant underwent single session of laser exposure. The laser parameters such as wavelength, spot area, power output and laser energy were set at 660 nm, 0.028 cm2, 60 mW/cm2, and 150 mW, respectively. The laser was subjected for a period of 30 s in each pocket.; A single session of full-mouth ultrasonic scaling using a sterilized scaler was rendered to the control group. Deep pockets were additionally approached and cleaned by using manual 'After Fives' Gracey curette for root planning (Hu Friedy Gracey After Five Vision curette; HuFriedy, Chicago, USA). This session was followed by a polishing session. A motivational session was conducted where the patients were educated on the importance of maintaining a good oral hygiene by brushing their teeth twice daily followed by the regular use of dental floss and chlorhexidine mouth wash twice daily, respectively.
Other intervention name(s): Photodynamic therapy; Scaling and root planing
Intervention MeSH terms: Methylene Blue
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: photodynamic therapy; biomarkers; inflammation; Rheumatoid arthritis; chronic periodontitis