Evaluation of photodynamic therapy using indocyanine green loaded chitosan nanoparticles, as an adjunct to non-surgical periodontal therapy in patients with stage I and II periodontitis". A randomized controlled trial.

BACKGROUND Almost 47 % of the population over the age group of 30 is affected by chronic periodontitis. Although the first and gold standard therapy in periodontal treatment is scaling and root planing (SRP), which is a non-surgical approach towards treatment, yet another therapy for the treatment of chronic periodontitis is to irradiate the periodontal pockets with laser. The purpose of this study was to confirm as to whether the use of diode laser (800 – 980 nm) as adjunct to scaling and root planning (SRP) improved the results of conventional mechanotherapy in the treatment of chronic periodontitis patients. METHODS In this study we designed our groups in such a way that 40 patients (20 males and 20 females) with two deepest nonadjacent pockets ≥ 5mm in two different quadrants were selected. In this study each treatment group belonged to a separate quadrant of the mouth. One group was allotted to SRP group while the second one was allotted to SRP + Diode Laser group. Clinical parameters like (Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), Bleeding on Probing (BOP) in chronic periodontitis patients were measured and evaluated at baseline, after 1 month and after 3 months of the treatment. Statistical analysis was also done intra group and inter group. RESULTS From this we infer that PPD was significantly reduced in SRP and SRP + Diode laser groups from baseline and post 1 month (P < 0.001), between baseline and post 3 months (P < 0.001) and between 1 month and 3 months (P < 0.001). There was also significant improvement in CAL in SRP and SRP + Diode Laser groups from baseline and post 1 month (P < 0.0001), between baseline and post 3 months (P < 0.0001) and between 1 month and 3 months (P < 0.0001). BOP also reduced in SRP and SRP + Diode Laser group from baseline. When SRP and SRP + Diode laser groups were compared they showed non statistically significant results but individually both the groups showed statistically significant results. CONCLUSIONS The results of the present study indicate that, comparison of SRP alone group which is a conventional method with SRP as adjunct to Diode laser group i.e., a non-surgical approach showed improvement of CAL and also reduction in PPD and BOP for the treatment of chronic periodontitis patients. KEY WORDS Periodontitis, Laser, Scaling and Root Planing, Adjunct Therapy, Diode Laser

The use of adjuncts like chlorhexidine local delivery and diode laser decontamination have been found to improve the clinical outcomes of scaling and root planing in non-surgical periodontal therapy in patients with chronic periodontitis. To evaluate the effects of diode laser and chlorhexidine chip as adjuncts to scaling and root planing in the management of chronic periodontitis. The objective is to evaluate the outcome of chlorhexidine chip and diode laser as adjuncts to scaling and root planing on clinical parameters like Plaque Index, Gingival Index, probing pocket depth and clinical attachment level. Department of Periodontics. Randomized clinical trial with split mouth design. Fifteen chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were included in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). Plaque Index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. Results were statistically analysed using paired T test, one-way ANOVA, Tukey's HSD test and repeated measure ANOVA. Post-treatment, the test and control sites showed a statistically significant reduction in PI, GI, PPD, and CAL. After three months, a mean PPD reduction of 1.47±0.52 mm in control group, 1.40±0.83 mm in diode laser group, 2.67±0.62 mm in CHX group, and 2.80± 0.77 mm in combination group was seen. The mean gain in CAL were 1.47±0.52 mm in the control group, 1.40±0.83 mm in diode laser group, 2.67± 0.49 mm in CHX group and 2.67± 0.82 mm in combination group respectively. The differences in PPD reduction and CAL gain between control group and CHX chip and combination groups were statistically significant (p<0.05) at three months, whereas, the diode laser group did not show any significant difference from the control group. Chlorhexidine local delivery alone or in combination with diode laser decontamination is effective in reducing probing pocket depth and improving clinical attachment levels when used as adjuncts to scaling and root planing in non-surgical periodontal therapy of patients with chronic periodontitis.

Photodynamic therapy (PDT) is a local noninvasive treatment modality without side effects caused by antibiotics. The aim of this study was to evaluate the efficacy of adjunctive use of PDT with scaling and root planing as compared with SRP alone in the treatment of chronic periodontitis. Twenty participants with chronic periodontitis having probing pocket depths (PDs) of ≥5 mm were selected for the study. Patients were randomly divided into control group and test group with ten patients in each group. Full-mouth SRP was performed in both the groups, followed by PDT in test group. Assessment of plaque index (PI), gingival index (GI), PD, and clinical attachment level (CAL) was done at baseline and after 3 months. Microbiological assessment of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola was done by polymerase chain reaction (PCR) at baseline and 3 months after the therapy. There was a significant reduction in PI, GI, PD, CAL, and microbiologic parameters in test group, following SRP and PDT, when compared with SRP alone in control group. PDT in conjunction with SRP has shown additional improvement in periodontal parameters when compared to SRP alone and has a beneficial effect in chronic periodontitis patients.

Periodontitis is a major cause of tooth loss among adults. Several studies have shown a possible systemic impact of periodontal infection, including poor glycemic control in patients with diabetes. Recently, photodynamic therapy (PDT) was used to successfully treat periodontal infection. PDT provides a broad spectrum antimicrobial efficacy with no local or systemic side effects. The objective of this study was to examine the effect of the adjunctive use of PDT on periodontal status and glycemic control of patients with diabetes and periodontitis. Forty-five patients with type 2 diabetes and moderate to severe chronic periodontitis were selected and randomly assigned to one of the following three treatment modalities (15 subjects each): scaling and root planing (SRP) only, SRP plus systemic doxycycline, and SRP plus PDT. The plaque and bleeding scores, probing depth, clinical attachment level, and glycosylated hemoglobin (HbA1c) level were recorded at baseline and 3 months after periodontal treatment. Descriptive statistics, the paired t test, and analysis of variance (ANOVA) were used for data analysis. Statistically significant differences in the mean probing depth, clinical attachment level, plaque deposit, and bleeding on probing were found between baseline and 12 weeks post-treatment for all groups. No significant differences in periodontal parameters and glucose levels were detected among the three groups. Reduction in the mean HbA1c level after treatment was observed in all groups but was only significant for the SRP plus doxycycline group. The results of the present study indicate that PDT does not benefit conventional non-surgical periodontal therapy in patients with diabetes.

To the Editor: Chronic periodontitis has been defined as a slowly progressive disease. Scaling and root planning (SRP) provides a satisfactory prognosis in most cases. However, due to the complex anatomy under gingiva, non-surgical periodontal treatment alone is difficult to prevent bacterial plaque recolonization and thoroughly eliminate dental calculus in deep pockets.[1] In recent years, the efficacy of indocyanine green (ICG)-mediated antimicrobial photodynamic therapy (aPDT) as an adjunct to non-surgical therapy has been explored in some research, but there are no consistent results. This meta-analysis followed the Cochrane Handbook for Systematic Review of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-analyses and was registered on PROSPERO with the registration number of CRD42020220606.[2] A literature search was performed before November 2020 in Cochrane Library, PubMed, and Embase. Reliability was verified by Kappa statistics, assuming that 0.61 was the threshold value. Inclusion criteria were as follows: (1) Research design was randomized controlled trial (RCT), which includes split-mouth design or full-mouth design. (2) The participants who had periodontal diseases were without restrictions in age, gender, ethnicity, or socioeconomic status. According to the American Academy of Periodontology/European Federation of Periodontology classification, periodontal disease was defined as clinical attachment loss (CAL) ≥2 mm at non-adjacent teeth, or CAL ≥3 mm with pocketing >3 mm for at least two teeth.[3] (3) Types of interventions: ICG-mediated photodynamic therapy as an adjunct to SRP vs. SRP alone. (4) Types of outcomes: the outcomes measured included the probing pocket depth (PPD) and CAL. Exclusion criteria were as follows: (1) Participants had a systematic disease. (2) Patients accepted antibiotic therapy or periodontal treatment within 3 months before the trial. (3) The participants were followed up for <3 months. (4) Medicine or other intervention approach was used in test groups. (5) High-power laser (output power was >1 W) was implemented in the test group. According to the Cochrane Tool for risk of bias assessment, the methodological quality was estimated. REVMAN 5.4 (Cochrane Collaboration, Cochrane Collaboration, Oxford, England) was utilized to calculate the overall effects in this meta-analysis. Mean difference (MD) and 95% confidence interval (95% CI) as the effect size were applied to describe continuous variables. Heterogeneity was calculated through Q-statistic and I2. Because of the moderate insensitivity for Q-statistic, P < 0.1 was deemed to represent significant heterogeneity. When I2 < 50%, we used the fixed-effects model. Otherwise, the random-effects model was used to measure the pooled effects. Statistical Z-test was elected for analysis. If P < 0.05, the pooled effects were considered to be statistically different. Sensitivity analysis was conducted to evaluate whether some literatures had a significant effect on overall outcomes. Egger's test was conducted to evaluate the publication bias by STATA 12.0 (Stata Corp LP, College Station, TX, USA). In this article, the primary outcomes were the PPD reduction and CAL gain at 1 month, 3 months, and 6 months. The secondary outcomes were the changes in plaque index (PI) at 1 month, 3 months, and 6 months. Seven hundred and twenty-two records were identified by retrieval strategy [Supplementary Figure 1, https://links.lww.com/CM9/B111]. Finally, a total of eight articles were eligible for this meta-analysis (κ = 0.79).[3-11] All the studies were RCTs and published from 2015 to 2020 [Supplementary Table 1, https://links.lww.com/CM9/B112]. The numbers of participants in every study were different, and 255 patients were enrolled in all trials. Two studies adopted full-mouth design and six studies adopted split-mouth design. For the clinical parameters, all studies adopted the 810 nm laser to irradiate ICG. Eight studies were evaluated for the risk of bias based on the Cochrane Handbook for Systematic Reviews of Interventions (RoB 2). Four studies were classified as having a low risk of bias and three studies as having a moderate risk of bias. One study had a high risk of bias. Four studies provided data on PPD and CAL and three studies provided the data of PI at 1 month. The PPD had a significant reduction for aPDT + SRP vs. SRP (MD = −1.08, 95% CI [−1.60, −0.55], P < 0.01). The CAL had no significant gain for aPDT + SRP group (MD = −0.81, 95% CI [−1.81, 0.18], P = 0.11). The PI reduction was not significant for aPDT + SRP group (MD = 0, 95% CI [−0.08, 0.07], P = 0.98). PPD and CAL were provided by seven studies at the 3-month follow-up, PI was provided by five studies. A significant reduction with strong evidence for heterogeneity was observed for PPD in aPDT + SRP group vs. SRP group (MD = −0.82, 95% CI [−1.48, −0.16], P = 0.01). The CAL had a significant reduction for aPDT + SRP group (MD = −0.60, 95% CI [−1.15, −0.05], P = 0.03). The difference in PI was not significant (MD = −0.08, 95% CI [−0.13, −0.03], P < 0.01) [Figure 1]. The data were provided by four studies at 6 months. Compared to SRP alone, ICG-mediated aPDT + SRP groups showed a significant reduction in PPD (MD = −0.81, 95% CI [−1.50, −0.12], P < 0.01), CAL (MD = −0.81, 95% CI [−1.08, −0.53], P < 0.01), except PI (MD = −0.27, 95% CI [−0.63, 0.10], P = 0.15). Sensitivity analysis was conducted to confirm the stability of this meta-analysis. A significant difference was not observed by the Egger's test. Therefore, there was no obvious publication bias.Figure 1: Forest plots of the effects of aPDT + SRP vs. SRP on patients with periondontal diseases in terms of (A) PPD, (B) CAL, and (C) PI at 3 months. aPDT: Antimicrobial photodynamic therapy; CAL: Clinical attachment loss; CI: Confidence interval; MD: Mean difference; PI: Plaque index; PPD: Probing pocket depth; SD: Standard deviation; SRP: Scaling and root planning.The maximum absorption peak of ICG is 805 to 810 nm, which means that the absorption peak wavelength of ICG can penetrate deeper tissue (6.0–6.5 mm).[12] As shown above, aPDT + SRP achieved exciting results in the short-term and intermediate-term, it suggested that ICG seemed to be a useful photosensitizer for periodontal treatment. In the present research, MD of PPD reduction kept stable during the period of follow-up. It showed that aPDT + SRP was more effective than SRP alone. On the other hand, clinical attachment had a significant gain at 3 months and 6 months. This meta-analysis was performed to explore the efficacy of ICG-mediated photodynamic therapy as an adjunct to conventional SRP therapy. The combination of two therapies could improve inflammation, attachment loss, plaque adhesion to a certain extent. Conflicts of interest None.

There is very low-certainty evidence (for long-term follow-up) to inform clinicians and patients if adjunctive systemic antimicrobials are of any help for the non-surgical treatment of periodontitis. There is insufficient evidence to decide whether some antibiotics are better than others when used alongside SRP. None of the trials reported serious adverse events but patients should be made aware of the common adverse events related to these drugs. Well-planned RCTs need to be conducted clearly defining the minimally important clinical difference for the outcomes closed pockets, CAL, PD, and BOP.

Background: Various locally delivered agent are used as an adjunct to scaling and root planning (SRP). 8- Hydroxydeoxyguanosine (8-OHdG) is best documented biomarker of oxidative stress in periodontitis. Objective: To evaluate the efficacy of locally delivered Ocimum sanctum gel by assessing the levels of 8-OHdG in Gingival crevicular fluid (GCF) of smokers and nonsmokers with periodontitis. Material and Methods: The study included 50 patients divided into 3 groups, group I - periodontally healthy, group II- smokers with stage II periodontitis and group III- non-smokers with stage II periodontitis. Smokers and non-smokers with stage II periodontitis received the locally delivered 10% OS gel as an adjunct to SRP at the test site at baseline and after 1 week recall, while SRP alone at control site. Result: 8-OHdG GCF levels were analyzed with enzyme-linked immunosorbent assay (ELISA) at baseline, and 6-months follow up. Probing pocket depth (PPD) in test site significantly reduced to 2.75 ±0.64, 2.50 ±0.68 at 6 month after periodontal therapy in group 2 and 3 respectively. Similarly, clinical attachment level (CAL) in test site significantly reduced to 3.15 ±0.81, 2.85 ±0.93 at 6 month after periodontal therapy in group 2 and 3 respectively. Conclusion: The application of 10% Ocimum sanctum L. gel showed significant improvement in PPD, CAL and PI and GI and reduction in GCF 8-OHdG levels.

Objective: The objective of this study was to evaluate the efficacy of the novel approach of non- surgical therapy using photodynamic laser therapy for treatment of periodontal lesions. Material and Methods: This study included 60 patients with at least one periodontal pocket ≤4 mm in all four quadrants of the mouth, without systemic disease and without prior 6-month use of antibiotics. A split-mouth design was used to compare treatment options for four quadrants: Scaling and Root Planning (SRP), SRP + Photodynamic Therapy (PDT), SRP + Low-Level-Laser-Therapy (LLLT) and basic therapy. Baseline, 3 and 6 months’ post-treatment periodontal examinations included Pocket Probing Depth (PPD), Clinical Attachment Level (CAL), Gingival Recession (GR), Gingival Index (GI), and Bleeding-on-Probing (BOP). Microbiological sampling from the periodontal pockets for anaerobic periopathogens using commercially available kits took place simultaneously with periodontal examinations. An examiner blinded to the treatment procedure used sterile paper point #50 for sampling from each quadrant and cultivated the material from the paper in a Schaedler terrain. The culture was put in a hermetically sealed bag with anaerobic-generator sacculus, incubated for 48 h and read with commercially available anaerobic ID cards in the Vitek-2? machine. Results: The results showed a significant reduction of PPD, CAL, GI and BOP for the quadrants treated with SRP + PDT, while SRP + LLLT and SRP alone showed similar results. When comparing CAL between the working groups, the SRP + PDT group showed significantly higher CAL gain than the other two study groups after 3 and 6 months (p < 0.01 and p < 0.001, respectively). The analysis of variance between the groups regarding the periodontal parameters, except for the GR, showed better results for the SPR + PDT group, but without any difference in microbiological findings. Conclusion: Photo-dynamic therapy, as an adjunct to the non-surgical method, may enhance mechanical debridement.

The aim of this study was to assess the efficacy of photodynamic therapy (PDT) as an adjunct to scaling and root planing (SRP) on clinical parameters and microbial composition in subgingival plaque of periodontitis patients. Seventeen patients were included in this split-mouth randomized clinical trial. Sites with probing pocket depth (PPD) ≥5mm in combination with bleeding on probing in different quadrants were randomized into the control group, the group with a single PDT application right after SRP, and the group with three repeated PDT applications 1week after SRP. The subgingival plaque was collected for 16S rRNA gene sequencing at baseline, Week 2, and Week 8. Seventeen patients with 60 sites completed this 8-week follow-up, and 157 subgingival plaques were successfully analyzed by sequencing. Significant improvements were observed in two primary outcomes: PPD at Week 8 and subgingival microbial composition. Compared to the control group, the repeated-PDT group showed a notable improvement in PPD, substantial alterations in the microbial profile, including a reduction in α-diversity and anaerobic bacteria, and an increase in aerobic bacteria at Week 2. Secondary outcomes, such as clinical attachment level and sulcus bleeding index, also showed improvement at Week 8. Furthermore, both the single- and repeated-PDT groups exhibited a decrease in periodontopathogens and an increase in beneficial bacteria compared with baseline. PDT promotes changes in the microbial composition of periodontitis patients' subgingival plaque in a direction favorable to periodontal health, and repeated PDT is a promising adjunctive therapy for periodontal treatment.

Antimicrobial photodynamic therapy adjuvant to non-surgical periodontal therapy in patients with diabetes mellitus: A meta-analysis

The aim of this study was to evaluate and compare the efficacy of subgingivally delivered 10% doxycycline hyclate and xanthan based chlorhexidine gels when used as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. A randomized, controlled, single center study was conducted involving 90 sites in 30 patients suffering from moderate to advanced chronic periodontitis. Each patient contributed three sites which were randomized to three treatment groups: SRP + insertion of doxycycline gel [SRP+DH], SRP + insertion of chlorhexidine gel [SRP+CHX]), and SRP alone [SRP]. Gingival index (GI), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded at baseline, 1 month, and 3 months post therapy. All treatments showed significant reductions in PPD and CAL at 1 and 3 months when compared to baseline values (p<0.001). At 3 months, sites treated with SRP+DH and SRP+CHX showed an additional reduction in PPD of 0.86 +/- 1.0 mm and 0.66 +/- 1.58 mm, respectively, significantly greater than SRP alone (p<0.02). Differences in mean PPD reduction between SRP+DH and SRP+CHX were not significant (p=0.46). At 3 months, differences in relative CAL between both SRP+DH (0.80 +/- 0.92) and SRP+CHX (0.63 +/- 1.47) and SRP alone were statistically significant (p<0.02). Differences in relative CAL between SRP+DH and SRP+CHX were not significant (p=0.54). The results suggest treatment with 10% doxycycline hyclate and xanthan based chlorhexidine gels as an adjunct to SRP improves PPD and CAL patients with periodontitis compared to SRP alone. The use of local drug therapy may refocus the need for surgical periodontal therapy toward deeper pockets.

Background:The purpose of this study was to clinically evaluate the benefits of sub gingival chlorhexidine (CHX) varnish and biodegradable CHX chip application used as an adjunct to scaling and root planning (SRP) as combined therapy and also to compare the effect of combined therapy with SRP alone.Materials and Methods:Fifteen patients with at least three sites with a probing pocket depth (PPD) of 5-8 mm were considered. Following baseline evaluation, all three sites were subjected for SRP. After completing SRP, each site was randomly subjected for CHX varnish, CHX chip application and the 3rd site was left without any medication as a control. Clinical parameters such as sulcus bleeding index, plaque index, bleeding on probing (BOP), PPD, and clinical attachment level (CAL) were recorded at baseline, 1 month and 3 months post-operatively.Results:All three groups presented with an improvement in clinical parameters compared to baseline. The mean reduction in PPD was 2.4 mm in SRP sites, 2.5 mm in SRP + CHX varnish sites and 2.8 mm in SRP + CHX chip sites. The mean gain in CAL was 2.4 mm in SRP sites, 2.3 mm in SRP + CHX varnish sites and 2.8 mm SRP + CHX chip sites.Interpretation and Conclusion:The present study indicated that application of CHX varnish and placement of CHX chip as an adjunct to SRP produced a clinically significant reduction in the PPD, BOP and a gain in CAL at 30th day and 90th day from baseline when compared to SRP alone. The results though were not statistically significant.

&lt;p&gt;&lt;strong&gt;BACKGROUND &amp;amp; AIM: &lt;/strong&gt;Photodynamic therapy is a localized non-invasive treatment modality for the periodontal disease. Some evidences have shown that this technique is effective in improving the treatment outcome. This study compared the effects of photodynamic therapy with and without scaling and root planing and scaling and root planing alone on the clinical parameters of the chronic periodontitis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;MATERIALS &amp;amp; METHODS: &lt;/strong&gt;In this single-blind, randomized clinical trial, 30 chronic periodontitis patients (10 for each modality) were selected and three different methods; photodynamic therapy alone (Group1) by FotoSan 630 system, scaling and root planning (SRP) alone (Group2), scaling and root planing combined with photodynamic therapy (Group3) were done for them randomly. Clinical parameters of probing pocket depth (PPD), bleeding on probing (BOP), and clinical attachment level (CAL) were measured at the baseline and 3, 6 and 12 weeks later. One-sided analysis of variance test was used to analyze PPD and CAL among the treatment groups in each time interval while the paired comparisons were carried out by employment of Dunnett’s test. The treatment groups were statically analyzed by the chi-square test regarding BOP. &lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;RESULTS: &lt;/strong&gt;Before the treatment; no significant differences observed among treatment modalities regarding clinical parameters; while the differences were significant at three weeks (p&amp;lt;0.0001 for PPD and CAL; p&amp;lt;0.001 for BOP); six weeks (p&amp;lt;0.0001 for PPD and CAL, p&amp;lt;0.002 for BOP); and 12 weeks after the treatment (all: p&amp;lt;0.0001). The least PPD and CAL values and the most frequency of non-bleeding on probing status were measured for PDT+SRP modality at three, six, and twelve weeks after the treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;CONCLUSION: &lt;/strong&gt;Photodynamic therapy supported the clinical parameters of periodontitis similar to SRP; however, PDT combined with SRP demonstrated a better result than that of SRP alone. Therefore, PDT combined with SRP can be used to improve outcomes of clinical parameters of periodontitis as compared to SRP alone in the short-term.&lt;/p&gt;

Aim: The study aims to evaluate the efficacy of probiotic chewable tablets (orocheck) containing Lactobacillus paracasei GMNL-33 along with non-surgical periodontal therapy on clinical parameters of mild to moderate chronic periodontitis (CP) patients. Methodology: This is a randomized controlled study conducted on 80 patients in the Department of Periodontics and Oral Implantology at Lenora Institute of Dental Sciences in Rajanagaram from January 2023 to April 2023. Patients were selected by toss-a-coin method; patients received scaling and root planing (SRP) and were randomly allocated into two treatment groups: Groups 1 and 2. Group 2 received chewable probiotic tablets (orocheck). All patients were asked to abstain from using other probiotic and antibiotic medication during the study period. Clinical parameters (plaque index, gingival index, probing pocket depth, clinical attachment level) are evaluated at baseline, 1 month, and 3 months in both groups. Statistical Analysis: Statistical analysis was conducted utilizing IBM Statistical Package for the Social Sciences software (SPSS) Version 23.0. Results: On intergroup analysis, statistically significant improvement in clinical parameters was observed in Group 2(SRP + PROBIOTIC) compared to Group 1 (SRP ALONE). Conclusion: The results indicated that oral administration of L. paracasei could be a useful adjunct to SRP in mild to moderate periodontitis.

Aims and Objectives:Harnessing Mother Nature's bountiful remedies for rejuvenation has been in vogue since time immemorial. Turmeric contains the polyphenol Curcumin in its rhizome. It produces reactive oxygen species (ROS) with visible light irradiation as photodynamic therapy (PDT) - which validates its use in the treatment of periodontitis. This study compares Curcumin and Curcumin PDT as an adjunct to conventional Scaling and Root Planing (SRP) with SRP alone in the treatment of patients with chronic periodontitis.Materials and Methods:Sixty sites in fifteen untreated chronic periodontitis patients were randomly assigned in a split mouth design for one of the treatment modalities; 1) Scaling and root planing (SRP) alone, (2) SRP + Curcumin application for 5 min, (3) SRP + Curcumin application for 5 min + irradiation with blue light emitting diode of wavelength 470 nm for 5 min. (Curcumin PDT) on 0 day.(4) SRP + Curcumin PDT on “0”, 7th and 21st day. The clinical parameters included plaque index (PI), bleeding on probing (BOP) measured by sulcus bleeding index (SBI), probing pocket depth (PPD), clinical attachment level (CAL) recorded at the baseline & 3rd month. The site with greatest probing pocket depth (PPD) was selected from each quadrant for bacterial sampling and culturing for Aggregatibacter actinomycetemcomitans (Aa) and other black pigment producing microorganisms (BPB) like Porphyromonas gingivalis & Prevotella intermedia.Conclusion:The present study showed that Curcumin photodynamic therapy is a valuable treatment modality adjunctive to conventional scaling and root planing over Curcumin application. Moreover, multiple adjunctive applications of photodynamic therapy are more beneficial than single application in reducing clinical & microbiological parameters.