Photodynamic Therapy with Curcumin and Chitosan as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis: A Clinical Study

Abstract

Background:Chronic periodontitis is an inflammatory condition leading to progressive attachment loss and alveolar bone destruction. Scaling and root planing (SRP) remains the standard non-surgical treatment; however, adjunctive therapies may enhance clinical outcomes. Curcumin and chitosan possess antimicrobial, anti-inflammatory, and wound-healing properties, and photodynamic activation may potentiate their effects. Aim: To evaluate the clinical efficacy of photodynamic therapy (PDT) with curcumin–chitosan gel as an adjunct to SRP in patients with mild to moderate chronic periodontitis. Materials and Methods: A randomized controlled clinical trial was conducted involving 24 patients diagnosed with mild to moderate chronic periodontitis. Participants were randomly assigned into two groups: Group A received SRP alone, and Group B received SRP followed by subgingival application of curcumin–chitosan gel with subsequent blue LED photoactivation. Clinical parameters—gingival index (GI), plaque index (PI), probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP)—were recorded at baseline, 15 days, 1 month, 3 months, and 6 months. Statistical analysis was performed using paired and unpaired t-tests, with p<0.05 considered significant. Results: Both groups showed significant improvement in all clinical parameters compared to baseline (p<0.05). Group B demonstrated greater reductions in GI, PI, PPD, and BOP, and greater CAL gain than Group A at all follow-up intervals. At 6 months, Group B showed a mean PPD reduction of 1.01 mm (p<0.001), CAL gain of 0.98 mm (p<0.001), GI reduction of 0.81 (p<0.001), PI reduction of 0.57 (p<0.001), and BOP reduction of 77.08% (p<0.001) from baseline. Conclusion: PDT with curcumin–chitosan gel as an adjunct to SRP resulted in superior improvements in periodontal health compared to SRP alone. This combination therapy offers a promising, minimally invasive approach for managing chronic periodontitis.