Effizienz der Photodynamischen Therapie mit dem Helbo-Verfahren - Erste Ergebnisse einer klinisch kontrollierten Studie bei parodontaler Entzündung (Teil I)

Die klassischen mechanischen Methoden der Therapie bzw. der adjuvante Einsatz von Antibiotika oder die Applikation von Antiseptika sind oft nicht ausreichend, um die parodontale Entzündung vollständig zu reduzieren. Die Ergebnisse der vorliegenden Studie sprechen für die zusätzliche Photodynamische Therapie mit dem Helbo-Verfahren bei entzündlichen Parodontalerkrankungen. Neben der signifikanten Reduktion der klinischen Entzündungszeichen wie Rötung und Bluten nach Sondieren können auch die messbaren Sondierungstiefen tendenziell vermindert werden.

Classical mechanical therapy methods and the adjuvant administration of antibiotics or antiseptics often are insufficient to completely suppress periodontal inflammation. The results of the present study point towards the benefit of additionally applying the Helbo-approach of the photodynamic therapy in case of inflammatory periodontal diseases. It not only causes a significant reduction of clinical symptoms of inflammation such as reddening and bleeding after probing but also tends to decrease the measured probing depths.

Schlüsselwörter

Alterszahnmedizin - interdisziplinäre Diagnostik und Therapie

Key Word

Photodynamic Therapy - Inflammatory Periodontal Diseases - Reduction of Clinical Symptoms

Literatur

• 1 Ashimoto A, Chen C, Bakker I, Slots J.. Polymerase chain reaction detection od 8 putative periodontal pathogens in subgingival plaque of gingivitis and advanced periodontitis lesions.  Oral Microbiol Immunol. 1996;  11 266-273
• 2 Bertoloni G, Salvato B, Dal'Acqua M, Vazzoler M, Jori G.. Hematoporphyrin-sensitized photoinactivation of Streptococcus faecalis.  Photochem Photobiol. 1984;  39 811-816
• 3 Bhatti M, MacRobert A, Meghji S, Henderson B, Wilson M.. A study of the uptake of toluidine blue O by Porphyromonas gingivalis and the mechanism of lethal photosensitization.  Photochemistry and Photobiology. 1998;  68
• 4 Chen C.. Periodontitis as a biofilm infection.  J Calif Dent Assoc. 2001;  29 362-369
• 5 Dörtbudak O, Haas R, Bernhart T, Mailath-Pokorny G.. Lethal photosensitization for decontamination of implant surfaces in the treatment of periimplantitis.  Clin Oral Impl Res. 2001;  12 104-108
• 6 Dougherty TH, Marcus SL.. Photodynamic therapy. Eur J Cancer 1992; 28A 1992: 1734-1742
• 7 Hayek RR, Araujo NS, Gioso MA, Ferreira J, Baptista-Sobrinho CA, Yamada AM, Ribeiro MS. Comparative study between the effects of photodynamic therapy and conventional therapy on microbial reduction in ligature-induced peri-implantitis in dogs.  J Periodontol. 2005;  76 1275-1281
• 8 Jorgensen MG, Aalam A, Slots J.. Periodontal antimicrobials - finding the right solutions.  Int Dent J. 2005;  55 3-12
• 9 Jorgensen MG, Slots J.. Practical antimicrobial periodontal therapy.  Compend contin Educ Dent. 2000;  21 111-114
• 10 Jorgensen MG, Slots J.. Responsible use of antimicrobials in periodontics.  J Calif Dent Assoc. 2000;  28 185-193
• 11 Kato H, Furukawa K, Sato M, Okunaka T, Kusonoki Y, Kawahara M, Fukuoka M, Miyazawa T, Yana T, Matsui K, Shiraishi H. T. Horinouchi. Phase II clinical study of photodynamic therapy using mono-Laspartyl chlorine e6 and diode laser for early superficial squamous cell carcinoma of the lung.  Lung Cancer. 2003;  42 103-111
• 12 Koenig K, Teschke M, Sigusch B, Glockmann E, Eick S, Pfister W.. Red light kills bacteria via photodynamic action.  Cell Mol Biol. 2000;  46 1297-1303
• 13 Lamster IB.. Current concepts and future trends for periodontal disease and periodontal therapy, Part 2: Classification, diagnosis, and nonsurgical and surgical therapy.  Dent Today. 2001;  20 86-91
• 14 Lovegrove JM.. Dental plaque revisited: bacteria associated with periodontal disease.  JNZ Soc Periodontol. 2004;  87 7-21
• 15 Lui H, Anderson RR.. Photodynamic therapy in dermatology. Shedding a different light on skin disease.  Arch Dermatol. 1992;  128 1631-1636
• 16 Mang TS, Allison R, Hewson G, Snider W, Moskowitz R.. A phase II/III clinical study of thin ethyl etiopurpurin (Purlytin)- induced photodynamic therapy fort he treatment of recurrent cutaneous metastatic breast cancer.  Cancer J Sci Am. 1998;  4 378-384
• 17 Martinetto P, Gariglio M, Lombard GF, Fiscella B, Boggio F.. Bactericidal effects induced by laser irradiation and haematoporphyrin against Gram-positive and Gram-negative microorganisms.  Drugs Exp Clin Res. 1986;  12 335-342
• 18 Meffert RM.. Periodontitis and periimplantitis: one and the same?.  Pract Periodontics Aesthet Dent. 1993;  5 79-80
• 19 Meisel P, Kocher T.. Photodynamic therapy for periodontal diseases: state of the art.  J Photochem Photobiol B. 2005;  13 159-170
• 20 Neugebauer J, Karapetian V, Kübler A, Zöller J.. Die antimikrobielle photodynamische Periimplantitistherapie.  J Implantol. 2004;  6 16-20
• 21 Nitzan Y, Guttermann M, Malik Z, Ehrenberg B.. Inactivation of Gram-negative bacteria by photosensitized porphyrins.  Photochem Photobiol. 1992;  55 89-96
• 22 Nitzan Y, Stainberg B, Malik Z.. Photodynamic effects of deuteroporphyrin on Gram positive bacteria.  Curr Microbiol. 1987;  15 251-258
• 23 Pallasch TJ.. Antibiotic resistance.  Dent Clin North Am. 2003;  47 623-639
• 24 Pass HI.. Photodynamic therapy in oncology: mechanisms and clinical use.  J Nat Cancer Inst. 1993;  85 443-456
• 25 Peng Q, Soler AM, Warloe T, Nesland JM, Giercksky KE.. Selective distribution of porphyrins in skin thick basal cell carcinoma after topical application of methyl 5-aminolevulinate.  J Photochem Photobiol B. 2001;  15 140-145
• 26 Pfitzner A, Sigusch BW, Albrecht V, Glockmann E. Killing of periodontopathogenic bacteria by photodynamic therapy.  J Periodontol. 2004;  75
• 27 Quirynen M, Teughels W, van Steenberghe D. Microbial shifts after subgingival debridement and formation of bacterial resistance when combined with local or systemic antimicrobials.  Oral Dis. 2003;  9
• 28 Quirynen M, Vogels R, Pauwels M, Haffajee AD, Socransky SS, Uzel NG, Steenberghe D.. Initial subgingival colonization of pristine pockets.  J Dent Res. 2005;  84 340-344
• 29 Rodrigues RM, Goncalves C, Souto R, Feres-Filho EJ, Uzeda M, Colombo AP.. Antibiotic resistance profile of the subgingival microbiota following systemic or local tetracycline therapy.  J Clin Periodontol. 2004;  31 420-427
• 30 Sbordone L, Bortolaia C.. Oral microbial biofilms and plaque-related diseases: microbial communities and their role in the shift from oral health to disease.  Clin Oral Investig. 2003;  7 181-189
• 31 Sigusch B, Beier M, Klinger G, Pfister W, Glockmann E.. A 2-step non-surgical procedure and systemic antibiotics in the treatment of rapidly progressive periodontitis.  J Periodontol. 2001;  72 275-283
• 32 Sigusch H. BW. Sigusch. Parodontitis - ein möglicher Risikofaktor für Allgemeinerkrankungen?.  ZWR. 2006;  10 436-442
• 33 Sigusch BW, Pfitzner A, Albrecht V, Glockmann E.. Efficacy of phototdynamic therapy on inflammatory signs and two selected periodontopathogenic species in a beagle dog model.  J Periodontal. 2005;  76 1100-1105
• 34 Sigusch BW, Pfitzner A, Güntsch A, Glockmann E.. Enhanced Root Planing and Systemic Metronidazole Administration Improves Clinical and Microbiological Outcomes in a 2-Step Treatment Procedure.  J Periodontol. 2005;  76 991-997
• 35 Sigusch BW, Voelpel A, Pfister W.. Wirksamkeit der Photodynamischen Therapie bei klinischen Entzündungszeichen des Parodonts und dem Nachweis parodontalpathogener Bakterienspezies - ein Fallbericht. Parodontologie 2007
• 36 Socransky SS, Haffajee AD.. Dental biofilms: difficult therapeutic targets.  Periodontology. 2000;  28 12-55
• 37 Soukos NS, Mulholland SE, Socransky SS, Doukas AG.. Photodestruction of human dental plaque bacteria: enhancement of the photodynamic effect by photomechanical waves in an oral biofilm model.  Lasers Surg Med. 2003;  33 161-168
• 38 Suzuki N, Yoshida A, Nakano Y.. Quantitative analysis of multi-species oral biofilms by TaqMan Real-Time PCR.  Clin Med Res. 2005;  3 176-185
• 39 Takanashi K, Kishi M, Okuda K, Ishihara K.. Colonization by porphyromonas gingivalis and Prevotella intermedia from teeth to osseointegrated implant regions.  Bull Tokyo Dent Coll. 2004;  45 77-85
• 40 Venezio FR, DiVincenzo C, Sherman R.. Bactericidal effects of photoradiation therapy with haematoporphyrin derivative.  J Infect Dis. 1985;  151 166-169
• 41 Walker C, Karpinia K.. Rationale for use of antibiotics in periodontics.  J Periodontol. 2002;  73 1188-1196
• 42 Wilson M.. Lethal photosensitization of oral bacteria and its potential application in the photodynamic therapy of oral infections.  Photochem Photobiol Sci. 2004;  3 412-418
• 43 Wilson M.. Photolysis of oral bacteria and is potential use in treatment of plaque-related diseases.  J Appl Bacteriol. 1993;  75 299-306
• 44 Yee KK, Soo KC, Olivo M.. Anti-angiogenic effects of hypericin-photodynamic therapy in combination with celebrex® in the treatment of human nasopharyngeal carcinoma.  Int J Mol Med. 2005;  16 993-1002

Korrespondenzadresse