Regular home use of dual-light photodynamic therapy as an adjunct to non-surgical periodontal treatment in smokers: a single-center randomized controlled clinical trial.

OBJECTIVES

This RCT assessed the effectiveness of daily home-applied dual-light antimicrobial photodynamic therapy (aPDT) as an adjunct to non-surgical periodontal therapy (NSPT) in smokers with Stage III or IV periodontitis.

MATERIALS AND

METHODS

Sixty smokers were randomized to receive either NSPT alone (control) or NSPT with daily for four months at-home application of aPDT, prior to oral hygiene (test group). Clinical parameters-bleeding on probing (BoP), probing depth (PD), clinical attachment loss (CAL), gingival recession (REC), full-mouth plaque score (FMPS), and Turesky Index-were assessed at baseline, 2 weeks, 4 months, and 6 months. aMMP-8 levels and patient-reported outcomes were also recorded.

RESULTS

Both groups demonstrated significant improvements in BoP, PD, and CAL (p < 0.05), but no significant intergroup differences were observed. BoP reduction at 2 weeks favored the test group (- 33.60% vs - 23.94%; p = 0.056). BoP continued to decrease at 4 and 6 months, reaching 29.55 ± 19.86% in the control group and 27.57 ± 16.43% in the test group at 6 months. The difference in mean BoP between the two groups at 6 months was not statistically significant (p = 0.680, Independent Samples Mann Whitney U Test). Plaque indices and aMMP-8 levels showed no significant differences. Compliance to dual-light aPDT averaged 77.7%; 72% of test participants were compliant. Greater compliance correlated with statistically significant improvements in mean values of all clinical parameters, whereas non-compliant patients presented with no changes (Related samples Friedman's Two-Way Analysis). Patient-centered outcomes revealed positive feedback, with 84% of the patients willing to recommend the device and minor adverse effects.

CONCLUSION

In smokers with advanced periodontitis, adjunctive home use of dual-light aPDT did not result in statistically significant improvements over NSPT alone in clinical parameters such as BoP, PD, or CAL. Future placebo-controlled, long-term clinical trials are warranted to further assess its potential role in supportive periodontal care.

CLINICAL RELEVANCE: Within the limitations of this study, dual-light aPDT cannot be recommended as a superior adjunct to conventional treatment.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05962801.