Effect Of Photodynamic Therapy On Non-Surgical Periodontal Therapy In Chronic Periodontitis Patients: A Randomized Clinical Trial

Abstract

Aim: Chronic periodontitis is an inflammatory condition affecting oral health due to bacterial biofilms and host immune responses. Although scaling and root planing (SRP) reduce bacterial load, deep-seated pathogens necessitate additional therapies. This randomized controlled split-mouth clinical study examined locally delivered unactivated methylene blue versus methylene blue activated as a photosensitizer in antimicrobial photodynamic therapy (APDT), combined with SRP.

Materials and Methods: Twenty patients with chronic periodontitis with pocket depth of ≥5mm at 3 different sites, were divided into three groups: Group I (SRP only), Group II (SRP with unactivated methylene blue), and Group III (SRP with laser-activated methylene blue). Each patient had two test sites and one control site. Test sites received SRP with activated methylene blue and laser therapy, while the other received SRP with unactivated methylene blue. The control site underwent SRP alone. Clinical parameters such as plaque index (PI), gingival index (GI), probing pocket depth (PD), clinical attachment level (CAL), and microbiological profiles were measured at baseline and after three weeks.

Results: Results showed that PDT with activated methylene blue led to significant improvements in plaque reduction, gingival health, and pocket depth compared to other groups. The improvement in CAL were non-significant between groups. Activated methylene blue in PDT significantly reduced levels of spirochetes and motile rods at three weeks and increased beneficial coccoid cells without adverse effects, minimizing microbial recolonization.

Conclusion: The study concluded that PDT with activated methylene blue has superior antimicrobial efficacy for managing chronic periodontitis compared to SRP alone or SRP with unactivated methylene blue.