Efficacy of Photodynamic Therapy Combined with Scaling and Root Planing in Treatment of Chronic Periodontitis: A Randomized Controlled Trial

Abstract

Chronic periodontitis represents a significant public health challenge in India, affecting approximately 50-60% of the adult population and imposing substantial economic burdens on both individuals and healthcare systems. This randomized controlled trial evaluated the clinical efficacy of photodynamic therapy (PDT) as an adjunct to conventional scaling and root planing (SRP) in treating chronic periodontitis among 120 patients in New Delhi, India. Participants were randomly allocated to either the control group receiving SRP alone or the experimental group receiving SRP combined with PDT using toluidine blue as a photosensitizer and diode laser activation at 630-660 nm wavelength. Clinical parameters including probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), and gingival index (GI) were assessed at baseline, 3 months, and 6 months post-treatment. Results demonstrated that the combination therapy yielded significantly superior outcomes compared to SRP alone, with mean PPD reduction of 3.2 ± 0.8 mm versus 2.1 ± 0.6 mm (p < 0.001), and CAL gain of 2.8 ± 0.7 mm versus 1.6 ± 0.5 mm (p < 0.001) at 6 months. The cost-effectiveness analysis revealed that despite higher initial treatment costs (₹8,500 versus ₹3,200), the combined approach demonstrated better long-term value through reduced retreatment requirements. These findings suggest that PDT-assisted periodontal therapy represents a promising advancement in managing chronic periodontitis in the Indian healthcare context, offering enhanced clinical outcomes with minimal adverse effects.