Efeito da terapia fotodinâmica antimicrobiana mediada pelo azul de metileno no tratamento da doença periodontal

Abstract

The standard therapy to treat periodontal disease today, being widely effective, consists of scaling and root planing (SRP). However, the inclusion of antimicrobial photodynamic therapy (aPDT) has been investigated as a promising complement in the improvement of periodontal clinical parameters. The purpose of this complete therapy is the use of the principle of activation of a photosensitizer (FS) through light energy, resulting in the transfer of energy or electrons to the environment, in order to form reactive oxygen species that, in turn, interact with various intracellular targets. The objective of this study was to perform a literature review to clarify the beneficial characteristics of aPDT, using methylene blue as an adjuvant in periodontal treatment. To this end, randomized clinical trials that used methylene blue as FS, published between 2009 and 2024 with a follow-up of at least 3 months, and involving patients with periodontitis who receive SRP alone and in association with aPDT, were selected. Thus, of 237 studies initially investigated with potential for inclusion, 24 were finally included in this review. Studies differ in clinical findings, however, it is possible to observe an improvement in periodontal clinical parameters, even if partially. The heterogeneity of the clinical protocols addressed in the studies makes a more homogeneous analysis difficult. Although the findings contribute to the implementation of this complementary step in the treatment of periodontitis, further clinical studies are needed, especially to analyze this therapy from the perspective of different patient profiles.