Abstract
Introduction: The aim of the present randomized controlled trial was to assess the effect of mechanical instru-mentation (MI) with adjunct photodynamic therapy (PDT) on salivary tumor necrosis factor-alpha (TNF alpha) 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 (TNF alpha) in peri-implant sulcular fluid were measured at baseline. The clinical and immunological pa-rameters 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, peri-odontal and peri-implant clinical parameters and TNF alpha 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 TNF alpha levels are higher after MI with or without PDT. In healthy patients, PDT offers no additional benefits in the treatment of periodontal inflammation.