Effect of mechanical instrumentation with adjunct photodynamic therapy on salivary TNFα levels and clinical periodontal and peri‑implant status in patients with depression: A randomized controlled trial

Shatha S ALHarthi; Darshan D Divakar; Abdulrahman Alwahibi; Munerah S BinShabaib

doi:10.1016/j.pdpdt.2022.103042

Effect of mechanical instrumentation with adjunct photodynamic therapy on salivary TNFα levels and clinical periodontal and peri‑implant status in patients with depression: A randomized controlled trial

Photodiagnosis Photodyn Ther. 2022 Dec:40:103042. doi: 10.1016/j.pdpdt.2022.103042. Epub 2022 Jul 29.

Authors

Shatha S ALHarthi¹, Darshan D Divakar², Abdulrahman Alwahibi³, Munerah S BinShabaib⁴

Affiliations

¹ Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
² Department of Oral Medicine and Radiology, Sharavathi Dental College and Hospital, Shivamogga, Karnataka 577204, India; Department of Oral Medicine and Radiology, Faculty of Dentistry, Levy Mwanawasa Medical University (LMMU), Ministry of Health, Lusaka 10101, Zambia.
³ Department of Psychiatry, College of Medicine, King Saud University, Medical City, Riyadh, Saudi Arabia.
⁴ Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia. Electronic address: MSbinshabaib@pnu.edu.sa.

PMID: 35908682
DOI: 10.1016/j.pdpdt.2022.103042

Abstract

Introduction: The aim of the present randomized controlled trial was to assess the effect of mechanical instrumentation (MI) with adjunct photodynamic therapy (PDT) on salivary tumor necrosis factor-alpha (TNFα) levels and clinical periodontal and peri‑implant status in patients with depression.

Materials and methods: In groups 1 and 2, individuals with periodontal and peri‑implant diseases with and without depression, respectively were included. Group-3 comprised of systemically healthy individuals with a healthy periodontal and peri‑implant status. In groups 1 and 2, patients in the test- and control groups received MI with and without PDT respectively. Periodontal and peri‑implant probing depth and plaque and gingival indices were measured. Radiographic evaluation was done at baseline. Whole salivary tumor necrosis factor alpha (TNFα) in peri‑implant sulcular fluid were measured at baseline. The clinical and immunological parameters were reassessed at 120 days' follow-up. Level of significance was set at P<0.05.

Results: Thirty-four, 36 and 37 implants were in function in groups 1, 2 and 3, respectively. At baseline, periodontal and peri‑implant clinical parameters and TNFα levels were significantly higher in groups 1 (P<0.05) and 2 (P<0.05) than Group-3. At 4-months follow-up, there was no difference in periodontal and peri‑implant clinical parameters in the test- and control groups among individuals in groups 1 and 3. In Group-2, there was a significant reduction in periodontal (P<0.05) and peri‑implant (P<0.05) clinical parameters at 4-months follow-up than baseline. In Group-2, there was no significant difference in these parameters among patients in the test- and control-groups.

Conclusion: In patients with depression clinical periodontal and peri‑implant status is poorer and salivary TNFα levels are higher after MI with or without PDT. In healthy patients, PDT offers no additional benefits in the treatment of periodontal inflammation.

Keywords: Clinical attachment loss; Cytokine; Depression; Implant; Photodynamic therapy; Probing depth; Saliva.

Publication types

Randomized Controlled Trial

MeSH terms

Humans
Inflammation
Periodontal Index
Photochemotherapy* / methods
Tumor Necrosis Factor-alpha

Substances

Tumor Necrosis Factor-alpha