Evaluation of Antimicrobial Photodynamic Therapy as an Adjuvant in Periodontal Treatment in Individual with Down Syndrome


  • Maria das Graças Barbosa da Silva
  • José de Alencar Fernandes Neto
  • Maria Helena Chaves de Vasconcelos Catão


Down Syndrome, Lasers, Photochemotherapy, Periodontal Diseases


Objective: To evaluate the effectiveness of Antimicrobial Photodynamic Therapy (aPDT), associated with scaling and root planing in the non-surgical periodontal treatment of individuals with Down Syndrome. Material and Methods: A controlled, randomized, split-mouth study was conducted. A total of 8 participants diagnosed with Down Syndrome aged 17-38 years of both sexes with clinical periodontitis were included in the study. Participants were treated at least three times: at the baseline, Plaque Index (PI), Bleeding on Probing (BOP), and Probing Pocket Depth (PPD) were obtained. After one week, conventional scaling and root planing were performed, and two quadrants were randomly selected for aPDT application. The reassessment was obtained one month after the aPDT application. The significance level was set at 5%. Analyses were performed considering a 95% confidence interval. Results: In the intergroup evaluation, no statistically significant differences were observed (p>0.05). In the intragroup evaluation, no statistically significant variations were observed in relation to the PI (p>0.05) and PPD (p>0.05); however, a statistically significant reduction in the BOP was observed between the test group (p=0.013) and control group (p=0.015). Conclusion: The use of aPDT as adjuvant therapy did not promote additional benefits in decreasing PI and PPD after 1 month of treatment. However, a significant reduction in the BOP was observed in the intragroup evaluation.


Ferreira R, Michel RC, Greghi SL, Resende MLR, Sant’Ana ACP, Damante CA, et al. Prevention and periodontal treatment in down syndrome patients: a systematic review. PLoS One 2016; 11(6):1-16. https://doi.org/10.1371/journal.pone.0158339

Abanto J, Ciamponi AL, Francischini E, Murakami C, Rezende NPM, Gallottini M. Medical problems and oral care of patients with Down syndrome: a literature review. Spec Care Dentist 2011; 31(6):197-203. https://doi.org/10.1111/j.1754-4505.2011.00211.x

Martins F, Simões A, Oliveira M, Luiz AC, Gallottini M, Pannuti C. Efficacy of antimicrobial photodynamic therapy as an adjuvant in periodontal treatment in Down syndrome patients. Lasers Med Sci 2016; 31(9):1977-81. https://doi.org/10.1007/s10103-016-2020-x

Albandar JM, Susin C, Hughes FJ. Manifestations of systemic diseases and conditions that affect the periodontal attachment apparatus: Case definitions and diagnostic considerations. J Periodontol 2018; 89(Suppl 20):S171-S189. https://doi.org/10.1002/JPER.16-0480

Andersen R, Loebel N, Hammond D, Wilson M. Treatment of periodontal disease by photodisinfection compared to scaling and root planing. J Clin Dent 2007; 18(2):34-8.

Christodoulides N, Nikolidakis D, Chondros P, Becker J, Schwarz F, Rössler R, et al. Photodynamic therapy as an adjunct to non-surgical periodontal treatment: a randomized, controlled clinical trial. J Periodontol 2008; 79(9):1638-44. https://doi.org/10.1902/jop.2008.070652

Theodoro LH, Silva SP, Pires JR, Soares GHG, Pontes AEF, Zuza EP, et al. Clinical and microbiological effects of photodynamic therapy associated with nonsurgical periodontal treatment. A 6-month follow-up. Lasers Med Sci 2012; 27(4):687-93. https://doi.org/10.1007/s10103-011-0942-x

Atieh MA. Photodynamic therapy as an adjunctive treatment for chronic periodontitis: a meta-analysis. Lasers Med Sci 2010; 25(4):605-13. https://doi.org/10.1007/s10103-009-0744-6

Campos GN, Pimentel SP, Ribeiro FV, Casarin RCV, Cirano FR, Saraceni CHC, et al. The adjunctive effect of photodynamic therapy for residual pockets in single-rooted teeth: a randomized controlled clinical trial. Lasers Med Sci 2013; 28(1):317-24. https://doi.org/10.1007/s10103-012-1159-3

Betsy J, Prasanth CS, Baiju KV, Prasanthila J, Subhash N. Efficacy of antimicrobial photodynamic therapy in the management of chronic periodontitis: a randomized controlled clinical trial. J Clin Periodontol 2014; 41(6):573-81. https://doi.org/10.1111/jcpe.12249

Cecatto RB, Magalhães LS, Rodrigues MFSD, Pavani C, Lino dos Santos Franco A, Gomes MT, et al. Methylene blue mediated antimicrobial photodynamic therapy in clinical human studies: The state of the art. Photodiagnosis Photodyn Ther 2020; 1-29. https://doi.org/10.1016/j.pdpdt.2020.101828.

De Paula Eduardo C, De Freitas PM, Esteves-Oliveira M, Aranha ACC, Ramalho KM, Simões A, et al. Laser phototherapy in the treatment of periodontal disease. A review. Lasers Med Sci 2010; 25(6):781-92. https://doi.org/10.1007/s10103-010-0812-y

Larson R, Farber B. Estatística Aplicada. 6th. ed. São Paulo: Pearson Prentice Hall, 2016. [In Portuguese].

Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol 2018; 89(Suppl 1):S159-S172. https://doi.org/10.1002/JPER.18-0006. Erratum in: J Periodontol 2018; 89(12):1475.

Morgan J. Why is periodontal disease more prevalent and more severe in people with Down syndrome? Spec Care Dentist 2007; 27(5):196-201. https://doi.org/10.1111/j.1754-4505.2007.tb00346.x

Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, et al. Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2018; 89(Suppl 1):S173-S182. https://doi.org/10.1002/JPER.17-0721

Cavalcante LB, Pires JR, Scarel-Caminaga RM. Periodontal disease in individuals with Down syndrome: genetic focus. RGO 2009; 57(4):449-53.

Siva NTD, Silva DNA, Azevedo MLDS, Junior FLS, Almeida ML, Longo JPF, et al. The effectiveness of photodynamic therapy as a complementary therapy to mechanical instrumentation on residual periodontal pocket clinical parameters: A clinical split-mouth test. Photodiagnosis Photodyn Ther 2020; 29:101565. https://doi.org/10.1016/j.pdpdt.2019.09.010

Berakdar M, Callaway A, Eddin MF, Ross A, Willershausen B. Comparison between scaling-root-planing (SRP) and SRP/photodynamic therapy: six-month study. Head Face Med 2012; 8(12):2-6.


Lang NP, Joss A, Orsanic T, Gusberti FA, Siegrist BE. Bleeding on probing. A predictor for the progression of periodontal disease?. J Clin Periodontol 1986; 13(6):590-6. https://doi.org/10.1111/j.1600-051x.1986.tb00852.x

Balata ML, Andrade LP, Santos DB, Cavalcanti AN, Tunes UR, Ribeiro EDP, et al. Photodynamic therapy associated with full-mouth ultrasonic debridement in the treatment of severe chronic periodontitis: a randomized-controlled clinical trial. J Appl Oral Sci 2013; 21(2):208-14. https://doi.org/10.1590/1678-7757201302366

Castro Dos Santos NC, Andere NM, Araujo CF, Marco AC, Santos LM, Jardini MAN, et al. Local adjunct effect of antimicrobial photodynamic therapy for the treatment of chronic periodontitis in type 2 diabetics: split-mouth double-blind randomized controlled clinical trial. Lasers Med Sci 2016; 31(8):1633-40. https://doi.org/10.1007/s10103-016-2030-8

Noro Filho GA, Casarin RC, Casati MZ, Giovani EM. PDT in non-surgical treatment of periodontitis in HIV patients: a split-mouth, randomized clinical trial. Lasers Surg Med 2012; 44(4):296-302. https://doi.org/10.1002/lsm.22016

Ramos UD, Ayub LG, Reino DM, Grisi MFM, Junior MT, Souza SLL, et al. Antimicrobial photodynamic therapy as an alternative to systemic antibiotics: results from a double-blind, randomized, placebo-controlled, clinical study on type 2 diabetics. J Clin Periodontol 2016; 43(2):147-55. https://doi.org/10.1111/jcpe.12498

Queiroz AC, Suaid FA, de Andrade PF, Oliveira FS, Novaes Jr AB, Taba Jr M, et al. Adjunctive effect of antimicrobial photodynamic therapy to nonsurgical periodontal treatment in smokers: a randomized clinical trial. Lasers Med Sci 2015; 30(2):617-25. https://doi.org/10.1007/s10103-013-1379-1

Lui J, Corbet EF, Jin L. Combined photodynamic and low-level laser therapies as an adjunct to nonsurgical treatment of chronic periodontitis. J Periodontal Res 2011; 46(1):89-96. https://doi.org/10.1111/j.1600-0765.2010.01316.x

Ahad A, Lamba AK, Faraz F, Tandon S, Chawla K, Yadav N. Effect of Antimicrobial photodynamic therapy as an adjunct to nonsurgical treatment of deep periodontal pockets: A clinical study. J Lasers Med Sci 2016; 7(4):220-6. https://doi.org/10.15171/jlms.2016.39

Moro MG, de Carvalho VF, Godoy-Miranda BA, Kassa CT, Horliana ACRT, Prates RA. Efficacy of antimicrobial photodynamic therapy (aPDT) for nonsurgical treatment of periodontal disease: a systematic review. Lasers Med Sci 2021; 36(8):1573-90. https://doi.org/10.1007/s10103-020-03238-1

Gursoy H, Ozcakir-Tomruk C, Tanalp J, Yılmaz S. Photodynamic therapy in dentistry: a literature review. Clin Oral Investig 2013; 17(4):1113-25. https://doi.org/10.1007/s00784-012-0845-7




How to Cite

Silva, M. das G. B. da ., Fernandes Neto, J. de A. ., & Catão, M. H. C. de V. . (2022). Evaluation of Antimicrobial Photodynamic Therapy as an Adjuvant in Periodontal Treatment in Individual with Down Syndrome. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 22, e200192. Retrieved from https://revista.uepb.edu.br/PBOCI/article/view/979



Original Articles