Antimicrobial Photodynamic Therapy Using Curcumin Photosensitizer in Conjunction with Periodontal Open Flap Debridement. Pilot Clinical Study with Real-Time PCR Bacterial Assessment

Aim: To evaluate the effect of using antimicrobial photodynamic therapy (A-PDT) with curcumin in conjunction with open flap debridement (OFD) in the treatment of deep periodontal pockets. The primary objective was the clinical evaluation via assessment of the changes in clinical periodontal parameters. The secondary objective was the quantification of the pocket total bacterial load by Real-Time PCR.
Subjects and methods: Group A included 7 patients who received OFD in conjunction with A-PDT using LED and curcumin paste (2%) as a photosensitizer. Group B included 7 patients who received OFD followed by application of curcumin paste (2%) but without photoactivation. Group C included 7 patients who received OFD alone. Clinical evaluation included plaque index (PI), gingival bleeding index (BI), probing depth (PD) and clinical attachment level (CAL). Microbiological evaluation involved collection of gingival crevicular fluid (GCF) samples for total bacterial load (TBL) analysis by real-time PCR
Results: Regarding the percent change in PD and CAL, the greatest percent decrease value was recorded in group A while the least percent decrease was in group C. The difference between groups was statistically significant. Regarding percent change of TBL by time, the greatest percent decrease value was recorded in group A.
Conclusion: Within the limitations of our study, the photoactivation of the curcumin used in conjunction with OFD may lead to greater PD reduction, greater CAL gain and greater TBL reduction when compared to OFD alone or OFD with curcumin without photoactivation.