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April 1, 2026

Clinical Efficacy of Adjunctive Photodynamic Therapy with Periodontal Regenerative Surgery in Severe Periodontitis: A Randomized Controlled Trial on Gingival Thickness Remodeling and Inflammatory Cytokine Modulation

Key Points

To evaluate the efficacy of combining photodynamic therapy with periodontal regenerative surgery in treating severe periodontitis.
Sixty patients were randomized into Combination (PDT + PTR) or Control (PTR) groups.
PDT used a 660 nm laser with methylene blue.
Outcomes measured included probing depth, clinical attachment loss, bleeding on probing, gingival thickness, and inflammatory cytokines at multiple time points.
At 12 months, the Combination group had greater reductions in probing depth and improvements in clinical attachment loss compared to Control.
The Combination group showed significantly less bleeding on probing and higher gingival thickness than the Control group.
Inflammatory markers decreased significantly at 3 months, with three-wall defects exhibiting better outcomes than two-wall defects.

Abstract

Objective: Assess clinical efficacy of photodynamic therapy (PDT) combined with periodontal regenerative surgery (PTR) in severe periodontitis, focusing on gingival thickness (GT), inflammatory markers, and bone repair. Methods: Sixty patients were randomized to Combination (PDT + PTR) or Control (PTR alone) groups. PDT utilized 660 nm laser with methylene blue. Outcomes included probing depth (PD), clinical attachment loss (CAL), bleeding on probing (BOP), keratinized tissue width (KTW), GT, cone-beam computed tomography bone parameters, and gingival crevicular fluid cytokines (IL-1β, TNF-α, PGE2, MMP-8) at 3/6/12 months. Results: At 12 months, Combination group showed superior PD reduction ( p < 0.05), CAL gain ( p < 0.05), lower BOP (16.67% vs. 43.33%, p < 0.05), increased KTW/GT, and enhanced bone density/defect filling versus Control. Inflammatory markers were significantly reduced at 3 months ( p < 0.05). Three-wall defects exhibited better CAL/GT outcomes than two-wall defects ( p < 0.05). Conclusions: The combined PDT and PTR therapy demonstrated significant improvements in key clinical parameters, reduced inflammatory biomarkers, and enhanced radiographic bone fill in severe periodontitis patients.

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