Photodynamic Therapy as an Adjunct in Periodontal Treatment

This study aims to evaluate the clinical effectiveness of antimicrobial photodynamic therapy (aPDT) as an adjunct to scaling and root planing (SRP) in the treatment of periodontitis. A split-mouth design will be used, in which one hemiarch receives conventional SRP and the contralateral hemiarch receives SRP combined with aPDT. Clinical periodontal parameters, including probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), plaque index (PI), and gingival index (GI), will be assessed at baseline and 30 days after treatment. The study seeks to determine whether adjunctive aPDT improves periodontal outcomes compared with conventional non-surgical periodontal therapy alone.

Inclusion Criteria: * Adults aged 18 to 65 years. * Diagnosis of Stage I, II, III, or IV periodontitis according to the 2018 World Workshop Classification. * Presence of at least two hemiarches with periodontal pockets ≥5 mm suitable for a split-mouth design. * Systemically healthy individuals. * No periodontal treatment received within the previous 6 months. * No use of antibiotics, anti-inflammatory drugs, or antiseptic mouth rinses within the previous 3 months. * Ability and willingness to provide written informed consent and attend follow-up visits. Exclusion Criteria: * Uncontrolled systemic diseases that may affect healing or immune response. * Use of antibiotics, corticosteroids, or immunosuppressive medications within the previous 3 months. * Active smokers consuming more than 10 cigarettes per day. * Pregnant or breastfeeding women. * Presence of dental implants, defective restorations, or teeth with Grade III mobility in the selected study sites. * Known allergy to toluidine blue O or any component of the photosensitizer. * Individuals unable or unwilling to attend the 30-day follow-up visit.