A clinico-microbiological and biochemical study evaluating the adjunctive use of antimicrobial photodynamic therapy and local drug delivery of 1.2 % simvastatin gel compared to scaling and root planing alone.

BACKGROUND: To evaluate and compare the efficacy of antimicrobial Photodynamic therapy (aPDT), Local Drug Delivery (LDD) of 1.2 % Simvastatin gel as an adjunct to scaling and root planning (SRP) and SRP alone in the treatment of Periodontitis using clinical, microbiological and biochemical parameters. MATERIALS AND METHODS: A total of 33 test sites in 11 Grade A Stage II periodontitis patients were randomly divided into three groups: GROUP I: Treated by SRP alone (SRP group); GROUP II: Treated by SRP followed by aPDT (aPDT group); GROUP III: Treated by SRP followed by single subgingival application of 1.2 % simvastatin gel (SMV group). Clinical parameters including API, PBI, PPD and RAL were assessed. Quantification of Porphyromonas gingivalis was evaluated by RT -PCR technique and estimation of RANKL levels was checked by ELISA. All assessments were done at baseline and 3 months RESULTS: All three groups showed significant reduction in the scores of clinical parameters, P. gingivalis DNA copy numbers and GCF RANKL levels at 3 months post therapy compared to baseline (p < 0.05). On comparison between the three groups, the results were non significant for all parameters both at baseline and at 3 months post therapy (p > 0.05). However slightly greater reduction was seen in the mean scores of PPD and RAL in the SMV Group and in P. gingivalis DNA copy numbers and GCF RANKL levels in aPDT group compared to the other groups although statistically non significant. A significant positive correlation(p < 0.05) was observed between P. gingivalis DNA copy numbers and PPD scores in SMV group and a significant negative correlation(p < 0.05) was observed between P. gingivalis DNA copy numbers and API & PBI scores in SRP group at 3 months follow up. CONCLUSIONS: aPDT, 1.2 % SMV local drug delivery as adjunct to SRP and SRP alone are effective in improving clinical parameters, reducing P. gingivalis DNA copy numbers and GCF RANKL levels. The superiority of one over another modality of treatment could not be established in this short term study.