Antimicrobial Photodynamic Therapy in the Post-Operative Extraction of Lower Third Molars: A Randomized and Blinded Clinical Trial
DOI:
https://doi.org/10.5335/rfo.v30i1.16960Keywords:
English, PortuguêsAbstract
Objective: This study aimed to evaluate local antimicrobial reduction protocols in post operative inflammatory-infectious events of lower third molar extractions. Methods It was a clinical, crossover, randomized and blind study with a sample of 22 patients (36 teeth). The patients underwent two surgical moments at intervals. The allocation of teeth was in 3 experimental groups: Group 1: Antimicrobial photodynamic therapy (aPDT); Group 2: 0.12% Chlorhexidine (CLX); Group 3: Control - 0.9% Saline Solution (SS 0.9%). The groups received treatment immediately after tooth extraction, and the evaluated parameters were: pain, edema, maximum mouth opening, and infection. Results: The data showed a statistically significant difference with aPDT therapy in edema, intragroup evaluation, and the distance between the gonial-tragus points (p = 0.022). In measuring mouth opening, there was a statistical difference in the intragroup assessment of aPDT and CLX (aPDT with p = 0.035, CLX with p = 0.038). There was a statistical difference in the presence of postoperative infection, with the aPDT and CLX groups showing the lowest values (p = 0.039). Regarding the pain, there was a decrease in the analysis on the 7th day of the aPDT group (P = 0.007). Conclusion: In conclusion, treatment with aPDT favors a statistically significant reduction of infection, edema, pain, and trismus in the postoperative period of third molar extractions.
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References
Jain S, Debbarma S, Prasad SV. Prevalence of impacted third molars among orthodontic patients in different malocclusions. Indian J Dent Res. 2019;30:238. DOI: 10.4103/ijdr.IJDR_373_17
Mercier P, Precious D. Risks and benefits of removal of impacted third molars: A critical review of the literature. Int J Oral Maxillofac Surg. 1992;21:17-27. DOI: 10.1016/S0901-5027(05)80131-8
Keeney KM, Yurist-Doutsch S, Arrieta MC, Finlay BB. Effects of antibiotics on human microbiota and subsequent disease. Annu Rev Microbiol. 2014;68:217-35. DOI: 10.1146/annurev-micro-091213-112330
Langdon A, Crook N, Dantas G. The effects of antibiotics on the microbiome throughout development and alternative approaches for therapeutic modulation. Genome Med. 2016;8:1-16. DOI: 10.1186/s13073-016-0294-z
Pedigo LA, Rao DV, Wu WH, McGuire K. Absence of bacterial resistance following repeat exposure to photodynamic therapy. Photodyn Ther Back Future. 2009;7380:73803H. DOI: 10.1117/12.827540
Fraga RS, Antunes LA, Bonan RF, Catunda IS, Antunes LS. Is antimicrobial photodynamic therapy effective for microbial load reduction in peri-implantitis treatment? A systematic review and meta-analysis. Photochem Photobiol. 2018;94:752-9. DOI: 10.1111/php.12907
Chatzopoulos GS, Doufexi AE. Photodynamic therapy in the treatment of aggressive periodontitis: A systematic review. Med Oral Patol Oral Cir Bucal. 2016;21:e192-200. DOI: 10.4317/medoral.20825
Lim KS, Kam PC. Chlorhexidine: Pharmacology and clinical applications. Anaesth Intensive Care. 2008;36:502-12. DOI: 10.1177/0310057X08036004079
Sajjan P, Laxminarayan N, Kar PP, Sajjanar M. Chlorhexidine as an antimicrobial agent in dentistry: A review. Oral Health Dent Manag. 2016;15:93-100. DOI: Not available.
Arteagoitia I, Andrés CR, Ramos E. Does chlorhexidine reduce bacteremia following tooth extraction? A systematic review and meta-analysis. PLoS One. 2018;13:1-18. DOI: 10.1371/journal.pone.0195592
Cho H, Park HJ, Choi SY, Kang SH. Effectiveness of irrigation with chlorhexidine after removal of mandibular third molars: A randomized controlled trial. Br J Oral Maxillofac Surg. 2018;56:54-9. DOI: 10.1016/j.bjoms.2017.10.010
Batinjan G, Jukić T, Gabrić D, Rupić I, Tarle Z. Thermographic monitoring of wound healing and oral health-related quality of life in patients treated with laser (aPDT) after impacted mandibular third molar removal. Int J Oral Maxillofac Surg. 2014;43:1503-8. DOI: 10.1016/j.ijom.2014.07.010
De Carvalho RWF, Vasconcelos BC. Pernambuco index: Predictability of the complexity of surgery for impacted lower third molars. Int J Oral Maxillofac Surg. 2017;47:234-40. DOI: 10.1016/j.ijom.2017.07.019
Clarke PR, Spear FB. Reliability and sensitivity in the self-assessment of well-being. Bull Br J Psychol. 1964;17:55. DOI: Not available.
Chukwuneke F, Onyejiaka N. Management of postoperative morbidity after third molars surgery: A review of the literature. Niger J Med. 2007;16:107-12. DOI: Not available.
López-Ramírez M, Vázquez-Delgado E, Gay-Escoda C. Efficacy of low-level laser therapy in the management of pain, facial swelling, and postoperative trismus after a lower third molar extraction: A preliminary study. Lasers Med Sci. 2012;27:559-66. DOI: 10.1007/s10103-011-0980-3
Farhadi F, Fazel MR, Salari Z, Etemad-Moghadam S. Evaluation of adjunctive effect of low-level laser therapy on pain, swelling and trismus after surgical removal of impacted lower third molar: A double blind randomized clinical trial. Laser Ther. 2017;26:181-7. DOI: 10.5978/islsm.17-OR-15
Rakasevic D, Puhar I, Tomic S, Jovanovic T, Petrovic A. Efficiency of photodynamic therapy in the treatment of peri-implantitis: A three-month randomized controlled clinical trial. Srp Arh Celok Lek. 2016;144:478-84. DOI: 10.2298/SARH1610478R.
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