Three-Arm Randomized Clinical Trial of Diode Laser 635 nm and 810 nm Photodynamic Therapy as Adjuncts to Non-Surgical Periodontal Treatment

This study aims to evaluate and compare the clinical effectiveness of antimicrobial photodynamic therapy (aPDT) using toluidine blue O (TBO) activated by two different diode laser wavelengths as an adjunct to non-surgical periodontal treatment in patients with Stage II and Stage III periodontitis. Participants will be randomly allocated to three treatment groups: non-surgical periodontal treatment combined with aPDT using a 635 nm diode laser, non-surgical periodontal treatment combined with aPDT using an 810 nm diode laser, and non-surgical periodontal treatment alone. The treatment outcomes will be evaluated based on changes in the following clinical periodontal parameters: Plaque Index (PI), Bleeding on Probing (BOP), Relative Attachment Level (RAL), Probing Depth (PD), and Gingival Recession (GR).

Inclusion Criteria: * Adults aged 18 years or older (up to 65 years) * Participants diagnosed with Periodontitis Stage II-III according to the 2017 classification * Presence of at least 3 periodontal sites with a probing pocket depth (PPD) of ≥ 5 mm. * No periodontal treatment during the previous 6 months * Good general health Exclusion Criteria: * Presence of systemic diseases or medical conditions that may affect periodontal status, wound healing, or the response to periodontal treatment. * Use of systemic antibiotics or other medications that may significantly affect periodontal treatment outcomes within the last 6 months. * Previous periodontal treatment within the last 6 months. * Known allergy or hypersensitivity to toluidine blue O or any material used in the study. * Pregnancy or breastfeeding. * Heavy smoking \>10 units/day