Assessing the Synergistic Benefits of Low-level Laser Therapy and Photodynamic Therapy as Adjuncts to Scaling and Root Planing in Chronic Periodontitis

Introduction: Low-level laser therapy (LLLT) facilitates tissue repair, alleviates pain, and reduces inflammation by modulating mitochondrial function, enhancing adenosine triphosphate synthesis, and regulating immune responses. It promotes collagen formation and growth factor release without producing thermal damage. Photodynamic therapy (PDT) involves the interaction of visible light, a biocompatible photosensitizing agent, and oxygen, leading to the generation of singlet oxygen and other reactive species that selectively destroy microbial cells while sparing surrounding tissues. Recently, green photosensitizers such as indocyanine green (ICG) have been introduced and are effectively activated using diode lasers. Objective: To assess, compare, and correlate plaque index (PI), gingival index (GI), sulcular bleeding index (SBI), pocket probing depth (PPD), and clinical attachment loss at baseline, 1 month, and 3 months following nonsurgical periodontal therapy (NSPT) alone and NSPT combined with LLLT and PDT. Materials and Methods: A split-mouth study design was employed involving 25 subjects aged between 30 and 60 years. In each participant, two quadrants were assigned as the control group receiving scaling and root planing (SRP) alone, while the remaining quadrants were allocated to test group 1 (SRP with LLLT) and test group 2 (SRP with PDT). Results: Both test groups demonstrated statistically significant improvements in PI, GI, SBI, PPD, and clinical attachment level at 1- and 3-month follow-up intervals compared to the control group ( P < 0.001). Conclusion: Adjunctive use of PDT employing ICG and LLLT in combination with SRP resulted in superior clinical outcomes when compared to SRP alone.