Efficacy of antimicrobial photodynamic therapy versus antiviral therapy in the treatment of herpetic gingivostomatitis among children: Aa randomized controlled clinical trial

Sajith Vellappally; Mohamed H Mahmoud; Samer M Alaqeel; Rasha N Alotaibi; Haitham Almansour; Omar Alageel; Mohamed Hashem; Hassan Fouad; Selma Saadaldin; Anil Sukumaran

doi:10.1016/j.pdpdt.2022.102895

Efficacy of antimicrobial photodynamic therapy versus antiviral therapy in the treatment of herpetic gingivostomatitis among children: Aa randomized controlled clinical trial

Photodiagnosis Photodyn Ther. 2022 Sep:39:102895. doi: 10.1016/j.pdpdt.2022.102895. Epub 2022 Apr 30.

Authors

Affiliations

¹ Dental Health Department, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia. Electronic address: svellappally@ksu.edu.sa.
² Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia.
³ Dental Health Department, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia.
⁴ Biomedical Engineering Department, Faculty of Engineering, Helwan University, Cairo, Egypt.
⁵ Schulich School of Medicine & Dentistry Western University London, Ontario, Canada.
⁶ Department of Dentistry-Oral Health Institute, Hamad Medical Corporation, Doha, Qatar; College of Dental Medicine, Qatar University, Doha, Qatar. Electronic address: anil.sukumaran.anil@gmail.com.

PMID: 35504550
DOI: 10.1016/j.pdpdt.2022.102895

Abstract

Aim: The aim of the present study was to evaluate the effect of antimicrobial photodynamic therapy (aPDT) as an adjunctive treatment to topical antiviral therapy for the treatment of children having herpetic gingivostomatitis.

Materials and methods: 45 individuals (age group 12-18 years) with herpetic gingivostomatitis (HG) were divided into three groups on the basis of provision of treatment. (a) Group A: topical anti-viral therapy (TAT) (n = 14, mean age = 17.0 years) (b) Group B: antimicrobial photodynamic therapy (aPDT) (n = 15, mean age =17.7 years) and (c) Group C: topical anti-viral therapy + adjunctive aPDT (n = 16, mean age = 18.0 years) respectively. Pain scores [visual analogue scale (VAS) and McGill Pain Questionnaire (MPQ)] were assessed and HSV-1 was quantified. ENZYME LINKED IMMUNOSORBENT ASSAY (ELISA) was used to compute the pro-inflammatory cytokine including interleukin 6 (IL-6) and tumor necrosis factor-alpha (TNF-α). The analysis of the mean values and inter group comparisons were evaluated with the Mann-Whitney test. The Friedman test was used to establish the comparison of the changes observed in HSV quantification, pain scores, and pro-inflammatory cytokines. ANOVA tests were employed for the quantification of differences observed at follow-ups. The assessments for the clinical trial were done at baseline, immediate after post-op, two, and four weeks, and three and six months respectively.

Results: According to the analysis of the data obtained after the clinical assessment, the three groups reported a decrease in the pain scores, HSV-1 quantification and levels of the pro-inflammatory cytokines. However, Group C (TAT + aPDT) reported improvement in the observed parameters which was statistically significant in comparison to Group A (TAT) and Group B (aPDT) respectively.

Conclusion: Antimicrobial photodynamic therapy (aPDT) in conjunction with topical antiviral therapy (TAT) helped in reducing the pain scores and pro-inflammatory cytokine levels in herpetic gingivostomatitis among children.

Keywords: Acyclovir; Anti-viral therapy; Gingivostomatitis; Herpes simplex virus; Photodynamic therapy; Visual analogue scale.

Publication types

Randomized Controlled Trial

MeSH terms

Adolescent
Anti-Bacterial Agents / therapeutic use
Anti-Infective Agents* / therapeutic use
Antiviral Agents / therapeutic use
Child
Cytokines
Humans
Pain / drug therapy
Photochemotherapy* / methods
Stomatitis, Herpetic* / drug therapy

Substances

Anti-Bacterial Agents
Anti-Infective Agents
Antiviral Agents
Cytokines