Klinički i mikrobiološki efekti primene fotodinamske terapije u nehirurškom lečenju parodontopatije
Sažetak
Uvod/Cilj. Lečenje parodontopatije prolazi kroz nekoliko faza. Kauzalna (inicijalna, bazična) faza lečenja parodontopatije predstavlja osnovnu terapijsku fazu kroz koju prolaze svi pacijenti. Antimikrobna fotodinamska terapija (aPDT) predstavlja jednu od savremenih i relativno novih mogućnosti, čija je uloga inaktivacija mikroorganizama odgovornih za nastanak i progresiju oboljenja. Cilj istraživanja bio je uporedna analiza kliničkih i mikrobioloških efekata primene samo kauzalne terapije i njene kombinacije sa aPDT. Metode. U prospektivnoj randomizovanoj studiji bila je primenjena metoda podeljenih usta. U istraživanju su bili praćeni sledeći klinički parametri: plak indeks (PI), krvarenje na provokaciju, dubina sondiranja (DS) i nivo pripojnog epitela (NPE). Metodom lančane reakcije polimeraze (PCR) praćeno je prisustvo mikroorganizama Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis i Treponema denticola. Testirani su uzorci pre, kao i tri meseca nakon terapije. Ispitivani su terapijski modaliteti kauzalne terapije i njene kombinacije sa aPDT. Rezultati. Analizirani klinički parametri: PI, krvarenje gingive, DS i NPE pokazali su statistički značajno poboljšanje nakon primene oba modaliteta lečenja (p < 0,001). Mikrobiološke analize pokazale su da je ukupni broj mikroorgnizama
bio statistički značajno manji primenom obe metode lečenja (p < 0,001). Mikroorganizmi Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis i Treponema denticola nalazili su se u statistički značajno manjem broju nakon primenjenih terapija (p < 0,001). Kauzalna terapija u kombinaciji sa aPTD je dovela do statistički značajnog poboljšanja kako kliničkih parametara, tako i mikrobiološkog statusa u odnosu na kauzalnu terapiju primenjenu samostalno. Zaključak. Istraživanje je pokazalo da je došlo do poboljšanja svih kliničkih pokazatelja nakon primene oba modaliteta lečenja. Ukupni broj mikroorganizama, kao i broj specifičnih mikroorganizama je bio smanjen. Kombinacija aPDT sa kauzalnom terapijom dovela je do statistički značajno većeg smanjenja broja mikroorganizama u poređenju sa samom kauzalnom terapijom.
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