Treatment efficacy of photoactivated disinfection versus Salvadora persica gel in experimental gingivitis

Abstract

Background: This clinical trial aimed to study the comparison of clinical gingival inflammatory scores and levels of pathogenic bacteria with professionally administered plaque removal (PAPR) with photoactivated disinfection (PAD) and Salvadora persica (SP) gel application in experimentally induced gingivitis.

Materials and methods: Twenty-five non-smoking patients underwent an 8-week experimental gingivitis trial that consisted of 14 days of undisturbed plaque accumulation and a 6 week of resolution phase following the three treatment modalities. The treatment protocols included PAPR with adjunctive PAD, SP gel application and PAPR alone. Clinical gingival inflammatory parameters including plaque index (PI) and bleeding on probing (BOP) were assessed. Microbiological parameters included the log count of five periodontal pathogens in the plaque from all experimental sites.

Results: No significant difference in plaque levels was observed between PAD, SP and PAPR at 2- and 6-weeks following treatment. The magnitude of the decrease was statistically significant at 6 weeks for SP (P = 0.02). The median number of residual BOP+ sites was higher at PAD and PAPR compared to SP at either 2-weeks (2.75 and 1.25, respectively; P = 0.039) or 6 weeks (2 and 1, respectively; P = 0.044) following treatment administration. Counts of all bacteria reduced until 2 weeks with significantly greatest reduction seen in the PAD group and this was maintained until 6 weeks of follow-up. The log CFU/mL values for all bacterial counts significantly reduced for SP group, however, it did not show significant reduction when compared with PAD but had greater extent when compared with PAPR group.

Conclusion: Both PAD and SP gel application improved clinical gingival inflammatory parameters in experimental-induced gingivitis. However, PAD helped to reduce bacterial counts, while SP had significant impact on bleeding in gingival inflammation.

Keywords: Bleeding on probing; Gingivitis; Photodynamic therapy; Salvadora persica.