Terapia fotodinâmica antimicrobiana como adjuvante ao tratamento não cirúrgico da periodontite
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Aug 7, 2025
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Resumo
Objetivo: Avaliar a eficácia da terapia fotodinâmica antimicrobiana como adjuvante ao tratamento peridontal não cirúrgico em pacientes com periodontite. Métodos: Trata-se de uma revisão integrativa da literatura onde foi realizada busca nas bases de dados PubMed, Cochrane e BVS, utilizando-se os descritores: “periodontitis, periodontal treatment, photobiomodulation, low power laser, antimicrobial photodynamic therapy", com o operador booleano AND. Critérios de inclusão: publicações entre 2014 e 2024 apresentando descritores no resumo e título; trabalhos em inglês, português e espanhol; estudos em humanos; estudos clínicos randomizados, de coorte e relatos de casos clínicos. Resultados: Foram recuperados 200 estudos. Após remoção das duplicatas, foram analisados títulos, resumos e idioma dos estudos e 40 foram excluídos. Dezoito estudos foram elegíveis, lidos na íntegra e incluídos. Considerações finais: A terapia fotodinâmica antimicrobiana possui eficácia quando combinada ao debridamento mecânico, produzindo melhora dos parâmetros clínicos, redução microbiológica das bactérias periodontopatogênicas, além de atuar na modulação inflamatória, cicatrização e reparação tecidual. Porém, são necessários mais estudos clínicos controlados randomizados com maior tempo de acompanhamento para consolidar sua eficiência e viabilidade na prática odontológica.
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Como Citar
QueirozM. S., MottaL. dos A., Vieira Ésio de O., SouzaA. A. e, AguiarT. R. da S., & CarvalhoP. A. (2025). Terapia fotodinâmica antimicrobiana como adjuvante ao tratamento não cirúrgico da periodontite. Revista Eletrônica Acervo Saúde, 25(8), e21182. https://doi.org/10.25248/reas.e21182.2025
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Referências
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2. ALASQAH MN, et al. Efficacy of methylene blue-mediated antimicrobial photodynamic therapy on clinical and radiographic outcomes among patients with periodontal diseases: A systematic review and meta-analysis of randomized controlled trials. Photodiagn Photodyn Ther, 2024; 46: 1572-1582.
3. ALVARENGA LH, et al. Parameters for antimicrobial photodynamic therapy on periodontal pocket- Randomized clinical trial. Photodiagn Photodyn Ther, 2019; 27: 132–6.
4. AL-ZAHRANI M, et al. Photodynamic therapy as an adjunctive to scaling and root planing in treatment of chronic periodontitis in smokers. Saudi Med J, 2011;32:1183-1188.
5. ARWEILER NB, et al. Six-month results following treatment of aggressive periodontitis with antimicrobial photodynamic therapy or amoxicillin and metronidazole. Clin Oral Investig, 2014;18(9):2129-2135.
6. BECHARA ANDERE NMR, et al. Evaluation of the local effect of nonsurgical periodontal treatment with and without systemic antibiotic and photodynamic therapy in generalized aggressive periodontitis. A randomized clinical trial. Clin Oral Investig, 2018; 24: 115-120.
7. BESTY J, et al. Efficacy of antimicrobial photodynamic therapy in the management of chronic periodontitis: a randomized controlled clinical trial. J. Clin. Periodontol, 2014;41(6): 573–581.
8. BRANCO FCSC, ESTEVES SRR. Terapia fotodinâmica com laserterapia no tratamento da periodontite crônica. Res Soc, 2022 11(15): e583111537897.
9. CARVALHO VF, et al. Antimicrobial photodynamic effect to treat residual pockets in periodontal patients: a randomized controlled clinical trial. J Clin Periodontol, 2015; 42(5): 440-447.
10. CATÃO MHCV, et al. Avaliação in vitro do efeito antibacteriano da terapia fotodinâmica com azul de metileno. Pesqui Bras Odontopediatria Clín Integr, 2020; 20: e4980, 2020.
11. CHITSAZI MT, et al. Clinical and Microbiological Effects of Photodynamic Therapy Associated with Non-surgical Treatment in Aggressive Periodontitis. J Dent Res Dent Clin Dent Prospects, 2014; 8(3): 153-159.
12. CORRÊA MG, et al. Short-term microbiological effects of photodynamic therapy in non-surgical periodontal treatment of residual pockets: A split-mouth RCT. Lasers Surg Med, 2016;48(10): 944-950.
13. CUNHA P, et al. Adjuvant antimicrobial photodynamic therapy cytokines in patients with type 1 diabetes mellitus. J Appl Oral Sci, 2024; 32: e20240258.
14. DICEMBRINI I, et al. Type 1 diabetes and periodontitis: prevalence and periodontal destruction-a systematic review. Acta Diabetol. 2020 Dec;57(12):1405-1412.
15. ELSADEK MF, FARAHAT MF. Effectiveness of photodynamic therapy as an adjunct to periodontal scaling for treating periodontitis in geriatric patients. Eur Rev Med Pharmacol Sci, 2022 26(6):1832-1838.
16. FERREIRA R, et al. Comparison of the effect of root surface modification with citric acid, EDTA, and aPDT on adhesion and proliferation of human gingival fibroblasts and osteoblasts: an in vitro study. Lasers Med, 2018; 3 (33): 533-538.
17. GBD 2017 DISEASE AND INJURY INCIDENCE AND PREVALENCE COLLABORATORS. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2018; 392: 1789-1858.
18. GHOLAMI L, et al. Clinical applications of antimicrobial photodynamic therapy in dentistry. Frontiers in microbiology. Front Microbiol, 2023; 13: 1020995.
19. GOMEZ HERNANDEZ C, et al. Aplicación complementaria de terapia fotodinámica y de la radiación láser de Er:YAG al tratamiento no quirúrgico de la periodontitis crónica: estudio comparativo de sus efectos clínicos, antiinflamatorios y antimicrobianos. Av Odontoestomatol, 2011; 27(3):147-160.
20. GORDILLO CAIZALUISA DC, et al. Efecto antimicrobiano de la terapia fotodinámica versus la terapia láser sobre la Porphyromona gingivalis: Estudio in vitro. Odontología, [S. l.], v. 20, n. 1, p. 20–32, 2018.
21. HOKARI T, et al. Effects of Antimicrobial Photodynamic Therapy and Local Administration of Minocycline on Clinical, Microbiological, and Inflammatory Markers of Periodontal Pockets: A Pilot Study. Int J Dent, 2018; e1748584.
22. KARUPPAN PMK, et al. Evaluating the potency of laser-activated antimicrobial photodynamic therapy utilizing methylene blue as a treatment approach for chronic. Front Oral Health, 2024;5: 1407201.
23. KOLBE MF, et al. Photodynamic Therapy During Supportive Periodontal Care: Clinical, Microbiologic, Immunoinflammatory, and Patient-Centered Performance in a Split-Mouth Randomized Clinical. J. Periodontal Res, 2014; 85(8): e277-e286.
24. MEYLE J, CHAPPLE I. Molecular aspects of the pathogenesis of periodontitis. Periodontol 2000, 2015; 69(1): 7-17.
25. MUNTEANU IR, et al. The Efficiency of Photodynamic Therapy in the Bacterial Decontamination of Periodontal Pockets and Its Impact on the Patient. Diagnostics, 2022; 12: 3026.
26. NIE M, et al. Efficacy of photodynamic therapy as an adjunct to scaling and root planing on clinical parameters and microbial composition in subgingival plaque of periodontitis patients: A split-mouth randomized clinical trial. J. Periodontol., 2022; 95(6): 535-549.
27. PAPAPANOU PN, 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(1): S173-S182.
28. PULIKKOTIL SJ, et al. Effect of photodynamic therapy adjunct to scaling and root planing in periodontitis patients: a randomized clinical trial. Aust Dent J, 2016; 61(4): 440-445.
29. RAJ KR, et al. Evaluation of efficacy of photodynamic therapy as an adjunct to nonsurgical periodontal therapy in treatment of chronic periodontitis patients: A clinico-microbiological study. Indian J Dent Res, 2016; 27(5): 483-487.
30. RAJESH S, et al. Antimicrobial photodynamic therapy: An overview. J Indian Soc Periodontol, 2011;15(4): 323-327.
31. SAHA A, et al. Comparative Evaluation of Conventional Therapy with and Without Use of Diode Laser (DL) in the Treatment of Chronic Generalized Periodontitis: A Clinico-Microbiological Study. Cureus, 2023; 15(3): e35720.
32. SANTOS, NCC, 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):1633-1640.
33. SANZ M, et al. Treatment of stage I-III periodontitis—The EFP S3 level clinical practice guideline. J. Clin. Periodontol, 2020; 47(22): 4-60.
34. THEODORO LH, et al. Comparison of repeated applications of aPDT with amoxicillin and metronidazole in the treatment of chronic periodontitis: A short-term study. J. Photochem. Photobiol. B, 2017; 174: 364-369.
35. TONETTI MS, et al. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: A call for global action. J. Clin. Periodontol, 2017; 44(5):456-462.
36. VILLAFUERTE KRV, et al. Benefits of antimicrobial photodynamic therapy as an adjunct to non-surgical periodontal treatment in smokers with periodontitis: a systematic review and meta-analysis. Medicina (Kaunas), 2023; 59(4): 684-94.
2. ALASQAH MN, et al. Efficacy of methylene blue-mediated antimicrobial photodynamic therapy on clinical and radiographic outcomes among patients with periodontal diseases: A systematic review and meta-analysis of randomized controlled trials. Photodiagn Photodyn Ther, 2024; 46: 1572-1582.
3. ALVARENGA LH, et al. Parameters for antimicrobial photodynamic therapy on periodontal pocket- Randomized clinical trial. Photodiagn Photodyn Ther, 2019; 27: 132–6.
4. AL-ZAHRANI M, et al. Photodynamic therapy as an adjunctive to scaling and root planing in treatment of chronic periodontitis in smokers. Saudi Med J, 2011;32:1183-1188.
5. ARWEILER NB, et al. Six-month results following treatment of aggressive periodontitis with antimicrobial photodynamic therapy or amoxicillin and metronidazole. Clin Oral Investig, 2014;18(9):2129-2135.
6. BECHARA ANDERE NMR, et al. Evaluation of the local effect of nonsurgical periodontal treatment with and without systemic antibiotic and photodynamic therapy in generalized aggressive periodontitis. A randomized clinical trial. Clin Oral Investig, 2018; 24: 115-120.
7. BESTY J, et al. Efficacy of antimicrobial photodynamic therapy in the management of chronic periodontitis: a randomized controlled clinical trial. J. Clin. Periodontol, 2014;41(6): 573–581.
8. BRANCO FCSC, ESTEVES SRR. Terapia fotodinâmica com laserterapia no tratamento da periodontite crônica. Res Soc, 2022 11(15): e583111537897.
9. CARVALHO VF, et al. Antimicrobial photodynamic effect to treat residual pockets in periodontal patients: a randomized controlled clinical trial. J Clin Periodontol, 2015; 42(5): 440-447.
10. CATÃO MHCV, et al. Avaliação in vitro do efeito antibacteriano da terapia fotodinâmica com azul de metileno. Pesqui Bras Odontopediatria Clín Integr, 2020; 20: e4980, 2020.
11. CHITSAZI MT, et al. Clinical and Microbiological Effects of Photodynamic Therapy Associated with Non-surgical Treatment in Aggressive Periodontitis. J Dent Res Dent Clin Dent Prospects, 2014; 8(3): 153-159.
12. CORRÊA MG, et al. Short-term microbiological effects of photodynamic therapy in non-surgical periodontal treatment of residual pockets: A split-mouth RCT. Lasers Surg Med, 2016;48(10): 944-950.
13. CUNHA P, et al. Adjuvant antimicrobial photodynamic therapy cytokines in patients with type 1 diabetes mellitus. J Appl Oral Sci, 2024; 32: e20240258.
14. DICEMBRINI I, et al. Type 1 diabetes and periodontitis: prevalence and periodontal destruction-a systematic review. Acta Diabetol. 2020 Dec;57(12):1405-1412.
15. ELSADEK MF, FARAHAT MF. Effectiveness of photodynamic therapy as an adjunct to periodontal scaling for treating periodontitis in geriatric patients. Eur Rev Med Pharmacol Sci, 2022 26(6):1832-1838.
16. FERREIRA R, et al. Comparison of the effect of root surface modification with citric acid, EDTA, and aPDT on adhesion and proliferation of human gingival fibroblasts and osteoblasts: an in vitro study. Lasers Med, 2018; 3 (33): 533-538.
17. GBD 2017 DISEASE AND INJURY INCIDENCE AND PREVALENCE COLLABORATORS. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2018; 392: 1789-1858.
18. GHOLAMI L, et al. Clinical applications of antimicrobial photodynamic therapy in dentistry. Frontiers in microbiology. Front Microbiol, 2023; 13: 1020995.
19. GOMEZ HERNANDEZ C, et al. Aplicación complementaria de terapia fotodinámica y de la radiación láser de Er:YAG al tratamiento no quirúrgico de la periodontitis crónica: estudio comparativo de sus efectos clínicos, antiinflamatorios y antimicrobianos. Av Odontoestomatol, 2011; 27(3):147-160.
20. GORDILLO CAIZALUISA DC, et al. Efecto antimicrobiano de la terapia fotodinámica versus la terapia láser sobre la Porphyromona gingivalis: Estudio in vitro. Odontología, [S. l.], v. 20, n. 1, p. 20–32, 2018.
21. HOKARI T, et al. Effects of Antimicrobial Photodynamic Therapy and Local Administration of Minocycline on Clinical, Microbiological, and Inflammatory Markers of Periodontal Pockets: A Pilot Study. Int J Dent, 2018; e1748584.
22. KARUPPAN PMK, et al. Evaluating the potency of laser-activated antimicrobial photodynamic therapy utilizing methylene blue as a treatment approach for chronic. Front Oral Health, 2024;5: 1407201.
23. KOLBE MF, et al. Photodynamic Therapy During Supportive Periodontal Care: Clinical, Microbiologic, Immunoinflammatory, and Patient-Centered Performance in a Split-Mouth Randomized Clinical. J. Periodontal Res, 2014; 85(8): e277-e286.
24. MEYLE J, CHAPPLE I. Molecular aspects of the pathogenesis of periodontitis. Periodontol 2000, 2015; 69(1): 7-17.
25. MUNTEANU IR, et al. The Efficiency of Photodynamic Therapy in the Bacterial Decontamination of Periodontal Pockets and Its Impact on the Patient. Diagnostics, 2022; 12: 3026.
26. NIE M, et al. Efficacy of photodynamic therapy as an adjunct to scaling and root planing on clinical parameters and microbial composition in subgingival plaque of periodontitis patients: A split-mouth randomized clinical trial. J. Periodontol., 2022; 95(6): 535-549.
27. PAPAPANOU PN, 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(1): S173-S182.
28. PULIKKOTIL SJ, et al. Effect of photodynamic therapy adjunct to scaling and root planing in periodontitis patients: a randomized clinical trial. Aust Dent J, 2016; 61(4): 440-445.
29. RAJ KR, et al. Evaluation of efficacy of photodynamic therapy as an adjunct to nonsurgical periodontal therapy in treatment of chronic periodontitis patients: A clinico-microbiological study. Indian J Dent Res, 2016; 27(5): 483-487.
30. RAJESH S, et al. Antimicrobial photodynamic therapy: An overview. J Indian Soc Periodontol, 2011;15(4): 323-327.
31. SAHA A, et al. Comparative Evaluation of Conventional Therapy with and Without Use of Diode Laser (DL) in the Treatment of Chronic Generalized Periodontitis: A Clinico-Microbiological Study. Cureus, 2023; 15(3): e35720.
32. SANTOS, NCC, 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):1633-1640.
33. SANZ M, et al. Treatment of stage I-III periodontitis—The EFP S3 level clinical practice guideline. J. Clin. Periodontol, 2020; 47(22): 4-60.
34. THEODORO LH, et al. Comparison of repeated applications of aPDT with amoxicillin and metronidazole in the treatment of chronic periodontitis: A short-term study. J. Photochem. Photobiol. B, 2017; 174: 364-369.
35. TONETTI MS, et al. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: A call for global action. J. Clin. Periodontol, 2017; 44(5):456-462.
36. VILLAFUERTE KRV, et al. Benefits of antimicrobial photodynamic therapy as an adjunct to non-surgical periodontal treatment in smokers with periodontitis: a systematic review and meta-analysis. Medicina (Kaunas), 2023; 59(4): 684-94.