Comparative evaluation of the effect of Ozone therapy and Photodynamic therapy in non-surgical management of Chronic periodontitis: A split mouth longitudinal study

Abstract

Background: A split-mouth longitudinal study was conducted to compare and evaluate the effect of ozonated water and photodynamic therapy (PDT) in nonsurgical management of chronic periodontitis, along with mechanical debridement procedure. Materials and Methods: Twenty-two patients diagnosed with chronic generalized periodontitis were subjected to the study. Following the assessment of gingival index, periodontal pocket depth, and clinical attachment loss, all patients underwent full-mouth scaling and root planing. Upper right and left quadrants of each patient were considered as sample sites in the study. Among these split-mouth sites, upper right quadrant of each patient was subjected to ozonated water irrigation with a 22-gauge needle and left upper quadrant was treated with PDT, which involved sulcus irrigation with indocyanine green dye (0.05 mg/ml) followed by low-level diode laser light application at 0.5 W and 810 nm (AMD Picasso) through a fiber-optic tip of 10 mm length, default angle of 60°, and fiber core diameter of 400 μm in noncontact continuous wave mode. Patients were recalled at the 2nd and 4th months regularly, and the therapy was repeated at the same sites in the same manner. Clinical parameters recorded before the study were assessed again at the end of the 2nd- and 6th-month period. Results: A statistically significant reduction (P < 0.05) was observed in gingival index scores within both the study groups at all intervals of the study. In Ozone therapy (OT) group, a statistically significant difference was noted for total periodontal pocket depth values between baseline and 2nd month (P = 0.000), baseline and 6th month (P = 0.000), and between 2nd month and 6th month (P = 0.029). In the PDT group, on contrary, a statistically significant difference was noticed in total periodontal pocket probing depth values between baseline and 2nd month (P = 0.000) and baseline to 6th month (P = 0.000), but a similar significant difference was not noticed between 2nd-month and 6th-month periods (P = 0.269). In group OT, a statistically significant difference was noted for total clinical attachment loss between baseline and 2nd month (P = 0.000), baseline and 6 months (P = 0.000), and 2nd month and 6th month (P = 0.019). In group PDT, a statistically significant difference in terms of its improvement was noted at intervals between baseline and 2 months (P = 0.000) and from baseline to 6 months (P = 0.000) but not between 2nd month and 6th month (P = 0.129). Conclusion: Results of the study showed that sub-gingival OT and PDT equally improved the clinical outcomes of treatment drastically following mechanical debridement at the end of first 2 months. Thereafter, it was shown to improve steadily throughout the study period, with slightly better results with OT compared with PDT.

Keywords

• chronic periodontitis
• nonsurgical therapy
• ozone therapy
• photodynamic therapy