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134]

Original Article

Photodynamic Therapy: Re‑entry in the Treatment of Chronic

Periodontitis: A Clinical Study
A. Suchetha, Latha Govindappa, N. Sapna, S. M. Apoorva, B. M. Darshan, Salman Khawar

Department of Background: Periodontitis is an inflammatory disease of multifactorial origin

Abstract
Periodontology, DAPM RV
Dental College, Bengaluru,
affecting the supporting tissues of the periodontium. Photodynamic therapy (PDT)
Karnataka, India involves the photosensitizer dye and a light source to induce reactive oxygen
species (singlet oxygen) and causes destruction of microorganisms. Aim: The
aim of this study was to compare the efficacy of PDT with scaling and root
planing  (SRP) and also to compare the efficacy of two different concentrations
of photosensitizer (methylene blue 0.005% and 0.01%) in the treatment of
chronic periodontitis. Materials and Methodology: Forty‑five patients affected
by moderate‑to‑severe chronic periodontitis were included in the study and were
divided into three groups. The clinical parameters, plaque index (PI), gingival
index (GI), and probing pocket depth were recorded at baseline, 1 month, and
3 months of time interval. After SRP, PDT was performed using methylene blue
dye (0.005% and 0.01%) and diode laser with 665 nm wavelength for 60 s.
Results: At 1 and 3  months after treatment, there were no statistically significant
differences between the groups with regard to reduction in PI, GI, and probing
pocket depth in all the three groups (P > 0.05). Conclusion: The additional
application of a single episode of PDT to SRP failed to result in an additional
improvement in terms of reduction in plaque score, GI score, and pocket probing
depth.
Keywords: Gingival index, periodontitis, photodynamic therapy, plaque index,
pocket probing depth, scaling and root planing

Clinical Relevance to Interdisciplinary Dentistry

• Photodynamic therapy (PDT) which can be used in the treatment of periodontitis
• PDT can be treated in the treatment of peri‑implantitis
• PDT can also be used in the disinfection of root canals.

Introduction it has some limitations and even with therapy, some

P eriodontitis is an inflammatory disease, which
is characterized by the presence of gingival
inflammation, periodontal pocket formation, loss of
connective tissue and alveolar bone of the teeth that
results from the extent of subgingival inflammation
induced by bacteria in the biofilm.[1] The main objective
of periodontal therapy is to eliminate deposits of bacteria
and bacterial niches by removing the supragingival
and subgingival biofilms.[2] Although mechanical
instrumentation is still regarded as important modality
which forms the gold standard of periodontal therapy,
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patients still have attachment loss probably due to the
persistence of periodontal pathogens and subsequent
recolonization of the subgingival area, which pose
a challenge for the patient and the therapist in plaque
control.[3] Thus, the advent of other options to improve
the effectiveness of periodontal therapy is needed due to
Address for correspondence: Dr. Latha Govindappa,
#45/1, 1st Main, 4th Cross, Chocolate Factory Road, Tavarekere,
BTM 1st Stage, Bangalore - 560 029, Karnataka, India.
E‑mail: lathagldc@gmail.com
This is an open access article distributed under the terms of the Creative Commons
Attribution‑NonCommercial‑ShareAlike 3.0 License, which allows others to remix, tweak,
and build upon the work non‑commercially, as long as the author is credited and the new
creations are licensed under the identical terms.
For reprints contact: reprints@medknow.com

How to cite this article: Suchetha A, Govindappa L, Sapna N, Apoorva SM,

DOI: Darshan BM, Khawar S. Photodynamic therapy: Re-entry in the
10.4103/jid.jid_74_16 treatment of chronic periodontitis: A clinical study. J Interdiscip
Dentistry 2017;7:15-22.

© 2017 Journal of Interdisciplinary Dentistry | Published by Wolters Kluwer ‑ Medknow 15

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Suchetha, et al.: Photodynamic therapy in the management of chronic periodontitis
limited access to furcation areas, concavities, grooves,
distal sites of molars, and deep pockets found during
conventional periodontal therapy.[4] The increase in
bacterial resistance due to the use of systemic antibiotics
could also justify the appearance of other adjuvants for
established periodontal treatment.[5,6]
Recent advances in technology have led to a constant
drive to develop novel approaches for the treatment of
periodontal diseases. Photodynamic therapy (PDT) is
also known as photoradiation therapy, phototherapy, or
photochemotherapy.[7]
Phototherapy began in ancient Greece, Egypt, and
India and was disappeared for decades. The use of
contemporary PDT was first reported by Danish
Physician, Niels Finsen. He successfully demonstrated
PDT by employing heat‑filtered light from carbon
arc lamp (The Finsen Lamp) in the treatment of lupus
vulgaris. PDT was introduced in medical therapy in
the year 1904 as the light‑induced inactivation of cells,
microorganisms, or molecules and is based on the
principle that a photosensitizer (i.e., a photoactivatable
substance) binds to the target cells and can be activated
by light of a suitable wavelength in the presence of
oxygen.[8]
PDT is an oxygen‑dependent photochemical reaction
that occurs upon exposure to a particular wavelength
of light in the presence of a suitable photosensitizer
dye. The various photosensitizer dyes were used
including (a) tricyclic dyes with different mesoatoms,
for example, acridine orange, proflavine, riboflavin,
methylene blue, toluidine blue, fluorescein, and
erythrosine, (b) tetrapyrroles, for example, porphyrins,
derivatives, chlorophyll, phylloerythrin, and
phthalocyanines, and (c) furocoumarins, for example,
psoralen and its methoxy derivatives, xanthotoxin, and
bergapten.
The various light sources were utilized including lasers of
different wavelengths and nonlaser light sources such as
light emitting diodes. The photochemical reaction results
in generation of cytotoxic species such as superoxide,
hydroxyl radicals, hydrogen peroxide, and singlet oxygen.
Among these, reactive oxygen species (singlet oxygen)
plays a major role in microbial destruction as it can
interact with a large number of biological substrates
inducing oxidative damage to the cell membrane and cell
wall of bacteria, fungi, and viruses.
Various studies have used different concentrations of
photosensitizer dye (0.01% or 0.005%), so the present
study was conducted to determine any variations in the
outcome of different concentrations applied in the PDT
procedure. The present study was aimed at evaluating
16 Journal of Interdisciplinary Dentistry  ¦  Volume 7  ¦  Issue 1  ¦  January-April 2017
the efficacy of PDT in the nonsurgical treatment of
chronic periodontitis with SRP and to compare the
efficacy of two different concentrations of methylene
blue (0.005% and 0.01%) photosensitizer.
Materials and Methodology
A total of 45 patients having chronic
periodontitis  (based on the 1999 Classification of
Periodontal Diseases and Conditions) were selected from
the outpatients visiting the Department of Periodontology,
DAPM RV Dental College, Bengaluru. The ethical
clearance for the study was obtained from the Ethical
Committee and review board of the institution. This
clinical study was conducted from October 2014 to April
2015. The patients of both sexes aged between 30 and
65 years, with a minimum of six teeth having periodontal
pocket depth of  ≥5  mm and with no systemic conditions
that would contraindicate routine periodontal procedures,
were included in the study. Patients with the following
criteria were excluded from the study: patients who have
received periodontal therapy within the past 6 months,
pregnant and lactating patients, patients who have taken
antibiotics within 6 months period preceding study, teeth
exhibiting Class II and Class III mobility, smokers,
acute oral infections, and patients with known allergy to
methylene blue dye. All participants signed the informed
consent form after being informed about the treatment
protocol.
Participants were divided into three groups as follows:
• Group I (n = 15): Those to be treated with scaling
and root planning (SRP) only
• Group II (n = 15): Those to be treated with
SRP + PDT (0.005% methylene blue) for the
treatment of chronic periodontitis
• Group III (n = 15): Those to be treated with
SRP + PDT (0.01% methylene blue) for the treatment
of chronic periodontitis.
All the patients were subjected to a full‑mouth periodontal
examination at six sites per tooth (excluding the third
molar). After oral hygiene instructions, all patients
received full‑mouth SRP under local anesthesia using both
hand instruments and ultrasonic device. The following
clinical parameters such as plaque index (PI) (Silness and
Loe 1964), gingival index (GI) (Loe and Silness 1963),
and pocket probing depth (PPD) (using UNC 15 Probe)
were recorded at baseline, 1 month, and 3 months. In
Group II and III participants after thorough SRP, safety
goggles were provided to the patient, operator, and the
assistant to prevent damage to the eyes by laser.
Using a blunt needle, the methylene blue photosensitizer
solution with a concentration of 0.005% and 0.01%,
respectively, was applied to the base of the pocket, starting
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Suchetha, et al.: Photodynamic therapy in the management of chronic periodontitis
from the apical end of the pocket moving coronally to
avoid entrapment of air bubbles. Three minutes later,
all pockets were thoroughly rinsed with sterile saline to
remove the excessive photosensitizer. Immediately after
rinsing, the diode laser (Sirona) with 660 nm wavelength
and 1 mW of output equipped with a fiber optic probe
tip was placed at the depth of the pocket and moved
circumferentially in sweeping motion around the teeth
for 1 min as shown in Figures 1-4. Patients were recalled
after 1 month and 3 months posttherapy and all the
clinical parameters were recorded. Statistical analysis was
carried out by one‑way analysis of variance (ANOVA).
Results
The mean PI scores at baseline, 1 month, and 3 months
were 2.58 ± 0.20, 1.25 ± 0.15, and 1.08 ± 0.08,
respectively, in Group  I; 2.37  ±  0.22, 1.19  ±  0.14, and
1.04  ±  0.07 in Group  II; and 2.31  ±  0.15, 1.15  ±  0.15,
and 1.05 ± 0.07, respectively, in Group III. The mean
PI was found to be statistically significant among all the
groups between all the time intervals (P < 0.05). The
results of PI are shown in Tables 1, 2 and Graphs 1, 4‑6.
The mean GI scores at baseline, 1 month, and 3 months
were 2.30 ± 0.23, 1.18 ± 0.13, and 1.05 ± 0.05,
respectively, in Group  I; 2.37  ±  0.18, 1.15  ±  0.13, and
1.07  ±  0.08, respectively, in Group  II; and 2.26  ±  0.20,
1.22 ± 0.12, and 1.06 ± 0.08, respectively, in Group III.
The mean GI was found to be statistically significant
among all the groups between all the time
intervals (P < 0.05). The result of GI is shown in
Tables 3, 4 and Graphs 2, 4‑6.
The mean PPD scores at baseline, 1 month, and
3 months were 6.69 ± 1.07, 5.59 ± 1.23, and 5.53 ± 1.33,
Figure 1: Preoperative pocket probing depth
Figure 3: Laser activation of methylene blue dye (photosensitizer)
Journal of Interdisciplinary Dentistry  ¦  Volume 7  ¦  Issue 1  ¦  January-April 2017
respectively, in Group  I; 6.29  ±  1.08, 5.88  ±  1.35, and
5.05  ±  1.05, respectively, in Group  II; and 6.40  ±  0.98,
5.65 ± 1.25, and 5.00 ± 1.02, respectively, in
Group III. The mean PPD was found to be statistically
significant among all the groups between all the time
intervals (P < 0.05); however, on intergroup comparison,
the mean PPD was found to be statistically significant
among all the groups (P ˃ 0.05). The result of PPD is
shown in Tables 5, 6 and Graphs 4‑6. On intergroup
comparison, the results of the study were statistically
insignificant (P ˃ 0.05) [Tables 2, 4, 6 and Graphs 4‑6].
Discussion
Periodontitis being multifactorial in etiology results in
loss of supporting tissues of the periodontium and also
presents with therapeutic difficulties. Microbial plaque
accumulation is considered to be one of the main factors
of this disease as bacteria have the ability to grow in
biofilms and are beyond the reach of antimicrobial
chemical agents. In addition, the anatomical complexity
of tooth roots causes them to be predisposed to the
development of many niches for bacterial deposits,
making eradication of periodontopathogens more difficult
both mechanically and chemically.
Furthermore, some periodontopathogens
(e.g., Aggregatibacter actinomycetemcomitans and
Porphyromonas gingivalis) can penetrate into and
persist in epithelial cells of the periodontal pockets and
the gingiva, thus avoiding the efficacy of conventional
antimicrobial drugs. In addition, the systemic
Figure 2: Application of methylene blue and saline irrigation to remove
the excess dye
Figure 4: Three months of posttreatment probing photos
17
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Suchetha, et al.: Photodynamic therapy in the management of chronic periodontitis
antibiotic therapy is limited by the minimum inhibitory
concentration of the drug, which is difficult to achieve
in gingival crevicular fluid and scarcely possible in
bacterial biofilms. Moreover, there is also a problem
of increasing bacterial resistance developing for the
systemic antibiotics.[9‑12]
Conventional treatment such as SRP does not completely
eliminate periodontal pathogens, especially in deep
periodontal pockets. Moreover, it does not prevent this
microorganism from penetrating into periodontal tissue.
In addition, this predisposes the periodontal pockets to
recolonization and recurrence of the disease.[13‑17]
PDT was discovered in the beginning of the 20th century
and then implemented in medicine. It consists of
three elements: harmless visible light, a nontoxic
photosensitizer, and oxygen. It is based on the principle
that the photosensitizer (or photoactivatable substance)
binds to the targeted cells and then can be activated by
light of the appropriate wavelength in the presence of
oxygen. This results in the generation of singlet oxygen
and free radicals, which are toxic to certain cells and
bacteria.[2,18‑21]
The mechanism of the action of antibacterial
PDT (aPDT) is that initially, a photosensitizer at ground
state is activated to a highly energized triplet state by
irradiation with the light of a certain wavelength. The
excited photosensitizer has a longer lifetime, which
results in interactions with the surrounding molecules,
and it is generally assumed that at the triplet state, the
generation of cytotoxic species occurs. The triplet‑state
photosensitizer reacts with biomolecules using two
different pathways (two types of reactions).[22]
Antimicrobial photosensitizers such as porphyrins,
phthalocyanines, and phenothiazines (e.g., methylene blue
and toluidine blue O) have been reported to penetrate
into Gram‑positive and Gram‑negative bacteria. The
positive charge seems to promote the binding of the
photosensitizer to the Gram‑negative bacterial membrane
and leads to its localized damage, resulting in an
increase in its permeability. Hence, toluidine blue O and
methylene blue are commonly used in aPDT.[23,24] Various
studies have been conducted previously using different
concentrations of methylene blue, but there were no
studies conducted to compare both concentrations.[25,26]
Hence, the present study was planned to evaluate the
efficacy of PDT with SRP, and also we compared the
efficacy of two different concentrations of methylene
blue photosensitizer in PDT.
The methylene blue photosensitizer gets activated at a
wavelength of 660 nm to 720 nm of laser light which is
in the red zone of light spectrum. In the present study,
18 Journal of Interdisciplinary Dentistry  ¦  Volume 7  ¦  Issue 1  ¦  January-April 2017
laser light (Sirona) with the wavelength of 660 nm was
used at 1 mW of energy. The depth of penetration of
laser light is ranging from 0.5 mm to 1.5 mm.
In the present study, all the precautions were followed
to prevent the laser‑associated damages to the patient as
well as to the operator. The clinical parameters observed
are PI, GI, and PPD.[25] Data obtained by the study were
analyzed by using ANOVA followed by Bonferroni
post hoc analysis.
The results obtained from this study showed that the
mean PI scores at baseline, 1 month, and 3 months in
Group I were 2.58 ± 0.20, 1.25 ± 0.15, and 1.08 ± 0.08,
respectively. In Group II, the mean PI scores at baseline,
1 month, and 3 months were 2.37 ± 0.22, 1.19 ± 0.14,
and 1.04 ± 0.07, respectively. In Group III, the mean
PI scores at baseline, 1 month, and 3 months were
2.31 ± 0.15, 1.15 ± 0.15, and 1.05 ± 0.07, respectively.
The mean PI was found to be statistically significant at
baseline (P < 0.05) between Group I and Group II but
was statistically insignificant at 1 month and 3 months of
time intervals (P ˃ 0.05) and was statistically insignificant
at all‑time intervals in Group III (P ˃ 0.05). However,
when compared between Group II and Group III,
Group II showed more reduction in PI scores at 1 month
and 3 months of time interval comparatively. The results
obtained in the present study in plaque reduction scores
were in agreement with the studies conducted by Ge
et al. and Berakdar et al.[25,26] In the present study, there
was no statistically significant reduction in plaque scores
observed.
The results obtained in this study showed that the
mean GI scores at baseline, 1 month, and 3 months in
Group I were 2.30 ± 0.23, 1.25 ± 0.15, and 1.08 ± 0.08,
respectively. In Group II, the mean PI scores at baseline,
1 month, and 3 months were 2.37 ± 0.22, 1.19 ± 0.14, and
1.04 ± 0.07, respectively. In Group III, the mean GI scores
at baseline, 1 month, and 3 months were 2.31 ± 0.15,
1.15 ± 0.15, and 1.05 ± 0.07, respectively. The mean
GI index score was found to be statistically significant
at baseline (P < 0.05) in Group I and Group II but was
statistically insignificant at 1 month and 3 months of time
intervals (P ˃ 0.05) and was statistically insignificant at
all‑time intervals in Group III (P ˃ 0.05). However, when
compared between Group II and Group III, Group III
showed more reduction in GI scores at 1 month and
3 months of time interval. The results obtained from this
study were in agreement with the study conducted by
de Oliveira et  al.[27,28] In the present study, there was no
statistically significant reduction in GI scores observed.
The results obtained from this study showed that the
mean PPD scores at baseline, 1 month, and 3 months in
Group I were 6.69 ± 1.08, 5.88 ± 1.35, and 5.53 ± 1.33,
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Suchetha, et al.: Photodynamic therapy in the management of chronic periodontitis

Table 1: Intragroup comparison of plaque index

Parameter Study group Time n Mean±SD Greenhouse‑Geisser Difference P
F P
Plaque index SRP Baseline 15 2.58±0.20 1 versus 2 768.493 <0.001* <0.001*
1 month 15 1.25±0.15 1 versus 3 <0.001*
2 months 15 1.08±0.08 2 versus 3 0.003*
SRP + PDT (0.005% MB) Baseline 15 2.37±0.22 394.535 <0.001* 1 versus 2 <0.001*
2 months 15 1.19±0.14 1 versus 3 <0.001*
3 months 15 1.04±0.07 2 versus 3 0.002*
SRP + PDT (0.01% MB) Baseline 15 2.31±0.15 437.912 <0.001* 1 versus 2 <0.001*
3 months 15 1.15±0.15 1 versus 3 <0.001*
4 months 15 1.05±0.07 2 versus 3 0.02*
1=Baseline, 2=1 month, 3=2 months. *Statistically significant. SRP=Scaling and root planing, PDT=Photodynamic therapy,
MB=Methylene blue, SD=Standard deviation

Table 2: Intergroup comparison of plaque index

Months Study groups n Mean±SD Minimum Maximum F P Difference P
Baseline SRP 15 2.58±0.20 2.07 2.86 8.396 0.001* 1 versus 2 0.02*
SRP + PDT (0.005%) 15 2.37±0.22 2.10 2.86 1 versus 3 0.001*
SRP + PDT (0.01%) 15 2.31±0.15 2.10 2.61 2 versus 3 1.00
1 month SRP 15 1.25±0.15 1.02 1.56 1.706 0.19 ‑ ‑
SRP + PDT (0.005%) 15 1.19±0.14 1.00 1.50 ‑ ‑
SRP + PDT (0.01%) 15 1.15±0.15 1.00 1.53 ‑ ‑
3 months SRP 15 1.08±0.08 1.00 1.22 1.404 0.26 ‑ ‑
SRP + PDT (0.005%) 15 1.04±0.07 1.00 1.22 ‑ ‑
SRP + PDT (0.01%) 15 1.05±0.07 1.00 1.22 ‑ ‑
*Statistically significant. SRP=Scaling and root planing, PDT=Photodynamic therapy, MB=Methylene blue, SD=Standard deviation

3.00 2.50
2.37
2.30
2.26
2.50 2.58
2.37 2.00
2.31
Mean Gingival Index
Mean Plaque Index

2.00
1.50
SRP SRP
1.50
SRP + PDT [0.005% MB] 1.18 SRP + PDT [0.005% MB]
1.25 1.15
1.00 1.22 1.05
1.19 SRP + PDT [0.01% MB] 1.06 SRP + PDT [0.01% MB]
1.00 1.15 1.08 1.07
1.05
1.04
0.50
0.50

0.00 0.00
BL 1 Month 2 Months BL 1 Month 2 Months

Graph 1: Intra group comparison of Plaque index (PI) Graph 2: Intra group comparison of Gingival index (GI)

respectively. In Group II, the mean PPD scores at
baseline, 1 month, and 3 months were 6.29 ± 1.07,
5.59 ± 1.23, and 5.05 ± 1.05, respectively. In Group III,
the mean PPD at baseline, 1 month, and 3 months were
6.40 ± 0.98, 5.65 ± 1.25, and 5.00 ± 1.02, respectively.
The mean PPD score was not found to be statistically
significant at all‑time intervals  (P ˃ 0.05). However,
when compared between Group II and Group III,
Group III showed more reduction in probing pocket depth
at baseline and 1 month of time interval comparatively.
The results obtained from this study were in agreement
with the study conducted by de Oliveira et al.[26,28] In
the present study, there was no statistically significant
reduction in probing pocket depth observed.
The results of the present study signify that the PDT
for the treatment of chronic periodontitis has similar
outcome that of conventional therapy (SRP). In the
present study, PDT did not show any added benefit over
SRP in the treatment of chronic periodontitis. In addition,
there was no statistically significant difference in the two
concentrations of photosensitizer dye in the treatment
outcome. Limitations of the study include small sample

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Suchetha, et al.: Photodynamic therapy in the management of chronic periodontitis

size, included in the study, short duration of observation,
and single application of PDT.
Conclusion
The results obtained from the present study concludes
that the conventional mechanical therapy and SRP alone
have a beneficial effect on the nonsurgical management
of chronic periodontitis, PDT as an adjunct to SRP did
not have any added benefit over the conventional SRP
alone. However, PDT showed similar clinical outcome as
that of SRP, and there was no difference in the clinical
outcome of two different concentrations of methylene

8.00
8.00

6.69

6.40
6.29
7.00
7.00
6.69 SRP
6.40 6.00
6.00 6.29 5.88 SRP + PDT [0.005% MB]
Mean PPD Scores

5.59 5.53 5.00 SRP + PDT [0.01% MB]

Mean Scores
5.00 5.65
5.00 SRP
5.05 4.00
4.00
SRP + PDT [0.005% MB]

2.58
2.37

2.37
2.31

2.30
3.00

2.26
3.00 SRP + PDT [0.01% MB]
2.00
2.00
1.00
1.00
0.00
0.00
PI GI PPD
BL 1 Month 2 Months

Graph 4: Inter-group comparison at baseline

Graph 3: Intra group comparison of Probing pocket depth (PPD)

5.53
7.00
6.00

5.05
5.00
5.88

5.65
5.59

6.00 5.00
SRP SRP

5.00 SRP + PDT [0.005% MB] SRP + PDT [0.005% MB]

4.00
SRP + PDT [0.01% MB] SRP + PDT [0.01% MB]
Mean Scores
Mean Scores

4.00
3.00
3.00
2.00
2.00
1.08

1.07
1.06
1.25

1.05
1.05
1.04
1.22
1.19

1.18
1.15
1.15

1.00 1.00

0.00 0.00
PI GI PPD PI GI PPD

Graph 5: Inter-group comparison at 1 month Graph 6: Inter-group comparison at 3 months

Table 3: Intragroup comparison of gingival index

Parameter Study group Time n Mean±SD Greenhouse‑Geisser Difference P
F P
Gingival index SRP Baseline 15 2.30±0.23 323.298 <0.001* 1 versus 2 <0.001*
1 month 15 1.18±0.13 1 versus 3 <0.001*
2 months 15 1.05±0.05 2 versus 3 0.007*
SRP + PDT (0.005% MB) Baseline 15 2.37±0.18 511.817 <0.001* 1 versus 2 <0.001*
2 months 15 1.15±0.13 1 versus 3 <0.001*
3 months 15 1.07±0.08 2 versus 3 0.08
SRP + PDT (0.01% MB) Baseline 15 2.26±0.20 316.447 <0.001* 1 versus 2 <0.001*
3 months 15 1.22±0.12 1 versus 3 <0.001*
4 months 15 1.06±0.08 2 versus 3 <0.001*
1=Baseline, 2=1 month, 3=2 months. *Statistically significant. SRP=Scaling and root planing, PDT=Photodynamic therapy, MB=Methylene
blue, SD=Standard deviation

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Suchetha, et al.: Photodynamic therapy in the management of chronic periodontitis

Table 4: Intergroup comparison of gingival index

Months Study groups N Mean±SD Minimum Maximum F P
Baseline SRP 15 2.30±0.23 2.00 2.65 1.010 0.37
SRP + PDT (0.005%) 15 2.37±0.18 2.10 2.76
SRP + PDT (0.01%) 15 2.26±0.20 2.00 2.57
1 month SRP 15 1.18±0.13 1.00 1.46 0.954 0.39
SRP + PDT (0.005%) 15 1.15±0.13 1.01 1.50
SRP + PDT (0.01%) 15 1.22±0.12 1.01 1.40
3 months SRP 15 1.05±0.05 1.00 1.20 0.108 0.90
SRP + PDT (0.005%) 15 1.07±0.08 1.00 1.22
SRP + PDT (0.01%) 15 1.06±0.08 1.00 1.24
SRP=Scaling and root planing, PDT=Photodynamic therapy, MB=Methylene blue, SD=Standard deviation

Table 5: Intragroup comparison of pocket probing depth

Parameter Study group Time n Mean±SD Greenhouse‑Geisser Difference P
F P
Pocket probing depth SRP Baseline 15 6.69±1.08 24.640 <0.001*
1 versus 2 <0.001*
1 month 15 5.88±1.35 1 versus 3 <0.001*
2 months 15 5.53±1.33 2 versus 3 0.16
SRP + PDT (0.005% MB) Baseline 15 6.29±1.07 61.111 <0.001* 1 versus 2 <0.001*
2 months 15 5.59±1.23 1 versus 3 <0.001*
3 months 15 5.05±1.05 2 versus 3 0.001*
SRP + PDT (0.01% MB) Baseline 15 6.40±0.98 50.070 <0.001* 1 versus 2 <0.001*
3 months 15 5.65±1.25 1 versus 3 <0.001*
4 months 15 5.00±1.02 2 versus 3 0.002*
1=Baseline, 2=1 month, 3=2 months. *Statistically significant. SRP=Scaling and root planing, PDT=Photodynamic therapy, MB=Methylene
blue, SD=Standard deviation

Table 6: Intergroup comparison of pocket probing depth

Months Study groups N Mean±SD Minimum Maximum F P
Baseline SRP 15 6.69±1.08 5.00 8.50 0.606 0.55
SRP + PDT (0.005%) 15 6.29±1.07 5.00 8.20
SRP + PDT (0.01%) 15 6.40±0.98 5.00 8.20
1 month SRP 15 5.88±1.35 4.00 8.00 0.214 0.81
SRP + PDT (0.005%) 15 5.59±1.23 4.00 7.40
SRP + PDT (0.01%) 15 5.65±1.25 4.00 7.50
3 months SRP 15 5.53±1.33 3.00 7.50 1.007 0.37
SRP + PDT (0.005%) 15 5.05±1.05 4.00 7.00
SRP + PDT (0.01%) 15 5.00±1.02 4.00 7.00
SRP=Scaling and root planing, PDT=Photodynamic therapy, MB=Methylene blue, SD=Standard deviation

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