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Eficácia da terapia fotodinâmica no tratamento da periodontite crónica: revisão sistemática
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A periodontite é uma condição inflamatória crónica que afeta os tecidos de suporte dos dentes, sendo a sua gestão um desafio clínico significativo. A terapia fotodinâmica (aPDT) tem sido proposta como uma abordagem adjuvante ao tratamento convencional, como a raspagem e alisamento radicular (RAR), pretendendo melhorar os resultados clínicos e microbiológicos. Esta revisão sistemática pretendeu identificar a eficácia da terapia de aPDT no tratamento complementar não cirúrgico da periodontite crónica, com base em estudos publicados entre 2015 e 2024. A pesquisa bibliográfica foi realizada nas bases de dados PubMed, ScienceDirect e B-On, tendo sido incluídos 17 estudos que cumpriram os critérios de elegibilidade. Em geral, a aPDT demonstrou potencial para melhorar os parâmetros clínicos em pacientes com periodontite. O uso do ICG mostrou reduções significativas nos parâmetros clínicos assim como a aPDT com azul de metileno também demonstrou eficácia, especialmente na redução da profundidade das bolsas periodontais e na melhoria do estado clínico geral. A redução de microrganismos patogénicos, como A. actinomycetemcomitans e P. gingivalis, foi observada, embora de forma variável. Em conclusão, a terapia fotodinâmica, especialmente quando combinada com RAR, pode ser considerada uma abordagem segura e eficaz no tratamento da periodontite, proporcionando reduções na profundidade das bolsas e melhorando os resultados microbiológicos. No entanto, mais estudos são necessários para estabelecer a superioridade da aPDT sobre os tratamentos convencionais, considerando a variabilidade dos resultados obtidos com diferentes fotossensibilizadores e protocolos de tratamento.
Periodontitis is a chronic inflammatory condition affecting the supporting tissues of the teeth, and its management is a significant clinical challenge. Photodynamic therapy (aPDT) has been proposed as an adjunctive approach to conventional treatment, such as scaling and root planing (SRP), aiming to improve clinical and microbiological outcomes. This systematic review aimed to identify the efficacy of aPDT therapy in the non-surgical adjunctive treatment of chronic periodontitis, based on studies published between 2015 and 2024. The literature search was performed in the PubMed, ScienceDirect and B-On databases, and 17 studies that met the eligibility criteria were included. In general, aPDT demonstrated potential to improve clinical parameters in patients with periodontitis. The use of ICG showed significant reductions in clinical parameters, while aPDT with methylene blue also demonstrated efficacy, especially in reducing periodontal pocket depth and improving overall clinical status. The reduction of pathogenic microorganisms, such as A. actinomycetemcomitans and P. gingivalis, was observed, although in a variable manner. In conclusion, photodynamic therapy, especially when combined with RAR, can be considered a safe and effective approach in the treatment of periodontitis, providing reductions in pocket depth and improving microbiological outcomes. However, further studies are needed to establish the superiority of aPDT over conventional treatments, considering the variability of results obtained with different photosensitizers and treatment protocols.
Periodontitis is a chronic inflammatory condition affecting the supporting tissues of the teeth, and its management is a significant clinical challenge. Photodynamic therapy (aPDT) has been proposed as an adjunctive approach to conventional treatment, such as scaling and root planing (SRP), aiming to improve clinical and microbiological outcomes. This systematic review aimed to identify the efficacy of aPDT therapy in the non-surgical adjunctive treatment of chronic periodontitis, based on studies published between 2015 and 2024. The literature search was performed in the PubMed, ScienceDirect and B-On databases, and 17 studies that met the eligibility criteria were included. In general, aPDT demonstrated potential to improve clinical parameters in patients with periodontitis. The use of ICG showed significant reductions in clinical parameters, while aPDT with methylene blue also demonstrated efficacy, especially in reducing periodontal pocket depth and improving overall clinical status. The reduction of pathogenic microorganisms, such as A. actinomycetemcomitans and P. gingivalis, was observed, although in a variable manner. In conclusion, photodynamic therapy, especially when combined with RAR, can be considered a safe and effective approach in the treatment of periodontitis, providing reductions in pocket depth and improving microbiological outcomes. However, further studies are needed to establish the superiority of aPDT over conventional treatments, considering the variability of results obtained with different photosensitizers and treatment protocols.
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Palavras-chave
Terapia fotodinâmica Fotoquimioterapia Periodontite crónica Raspagem dentária Photodynamic therapy Photochemotherapy Chronic periodontitis Dental scaling