Open flap debridement compared to repeated applications of photodynamic therapy in the treatment of residual pockets: A randomized clinical trial

Naira M.R.B. Andere, Nídia C. Castro dos Santos, Cássia F. Araújo, Hélvis E.S. Paz, Luciana M. Shaddox, Renato C.V. Casarin, Mauro P. Santamaria

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: The aim of the present study was to compare repeated applications of antimicrobial photodynamic therapy (aPDT) to open flap debridement (OFD) in the treatment of residual periodontal pockets in non-furcation sites. Methods: Forty-six subjects with a diagnosis of Stage III or IV Grade C periodontitis, that had been previously treated, participated in the study. Residual pockets were divided between two groups: (1) aPDT group: received ultrasonic periodontal debridement followed by immediate application of aPDT, and repeated on1st, 2nd, 7th, and 14th days; and (2) OFD group: treated by modified papilla preservation technique, where granulation tissue and visible calculus were removed with hand curettes and an ultrasonic device. Clinical, immunological, and microbiological parameters were evaluated before and after treatment. Results: Both treatments were effective reducing clinical parameters of disease. OFD resulted in a greater mean probing pocket depths (PPD) reduction in deep pockets (p = 0.001). However, aPDT resulted in a lower occurrence of gingival recession (GR), dentin hypersensitivity (DH) and analgesic intake. Reduction in Porphyromonas gingivalis was observed in both groups. Only the OFD group had a significant reduction in Aggregatibacter actinomycetemcomitans. aPDT group had greater increase in interleukin 10 (IL-10) levels and a greater reduction of interleukin 1 beta (IL-1β) at 14 days when compared to the OFD group (p < 0.05). Conclusion: OFD was superior in reducing PPD in deep pockets compared to the aPDT. However, OFD resulted in greater GR. Both treatments lowered P. gingivalis levels but only OFD reduced levels of A. actinomycemtemcomitans.

Original languageEnglish
Pages (from-to)1671-1681
Number of pages11
JournalJournal of Periodontology
Issue number11
StatePublished - Nov 2022

Bibliographical note

Funding Information:
The authors appreciate the financial support provided by Research Funding Agency from São Paulo State (FAPESP), Brazil, grant #2016/15143‐0 and 2017/05101‐0. In addition, this study was funded in part by the Coordination for the Improvement of Higher Education Personnel (CAPES), Brazil – Finance Code 001.Dr Mauro P Santamaria is supported by the National Council for Scientific and Technological Development from Brazil, CNPq (grant # 304269/2019‐0).

Publisher Copyright:
© 2022 American Academy of Periodontology.


  • antiinfective agents
  • gingival recession
  • periodontal debridement
  • periodontal pocket
  • periodontitis
  • photodynamic therapy
  • surgical procedure
  • ultrasonic

ASJC Scopus subject areas

  • Periodontics


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