Indocyanine green-based adjunctive antimicrobial photodynamic therapy for treating chronic periodontitis: A randomized clinical trial

Background: The objective was to evaluate the efficiency of indocyanine green (ICG)-based adjunctive antimicrobial photodynamic therapy (aPDT) in a prospective clinical study regarding non-surgical treatment of chronic periodontitis.

Methods: Affected teeth of twenty patients were treated with scaling and root planing (control group). Using a split-mouth design, two quadrants received additional ICG-based (perio green®, 0.1 mg/ml) aPDT (test group) with a diode laser at 808 nm (100 mW at 2 kHz). Clinical assessment of bleeding on probing (BOP), sulcus fluid flow rate (SFFR) and microbiological analysis were performed at baseline, two weeks, three and six months after treatment. Relative attachment level (RAL), probing depths (PD) and gingival recession (GR), were also analyzed.

Results: At baseline, none of the assessed parameters showed significant differences between the test and control groups. Median values for BOP, RAL, PD, decreased significantly in both groups after three months of treatment (p ≤ 0.05) without significant difference between the groups. Two weeks after treatment, the SFFR showed significantly lower mean values in the test group (aPDT).

Conclusion: Within the study limits, the only significant difference between the control group and the aPDT group was a transient smaller amount of SFFR in the latter during the first follow-up. With the applied parameters, this study does not conclusively support ICG-based aPDT, though it is promising because no adverse effects occurred. The precise modes of action of ICG must be elucidated, and further clinical trials are needed.