Effects of laser and indocyanine-green mediated antimicrobial photodynamic therapy on the red complex bacteria and crevicular procalcitonin level in periodontitis patients: A split-mouth randomized clinical trial

Abstract

Abstract Objective: To determine the effects of laser and photodynamic therapy (PDT) on crevicular procalcitonin (PCT) and red complex bacteria in patients with periodontitis stage II grade A. Methods: Sixty-six sites with periodontitis were selected. After scaling and root planing (SRP), participants were randomized to receive 810-nm diode laser and PDT using indocyanine green (ICG). The primary outcome was the change in crevicular PCT levels and red complex bacterial loads measured using the BAPNA assay. Secondary outcomes included probing depth (PPD), clinical attachment loss (CAL), relative attachment level (RAL), plaque index, and gingival index, assessed at baseline and 3 months post-intervention. Results: Significant improvements (P < 0.001) were observed for all variables within each group at the 3-month follow-up compared to baseline. Among the treatment groups, SRP+ICG-PDT demonstrated a greater reduction in BAPNA and PCT levels compared to SRP+laser and SRP alone. Correlation analysis between BAPNA and PCT revealed a significant positive correlation (r = 0.64; p = 0.001). Conclusion: In patients with periodontitis stage II grade A, a single application of PDT using 810-nm laser and ICG provided enhanced benefits compared to SRP alone or SRP+laser in terms of reducing red complex bacterial load and gingival crevicular procalcitonin levels at the 3-month follow-up.