Evaluation of photodynamic therapy using indocyanine green loaded chitosan nanoparticles, as an adjunct to non-surgical periodontal therapy in patients with stage I and II periodontitis". A randomized controlled trial.

BACKGROUND

Periodontitis is a chronic inflammatory condition marked by progressive attachment loss and bone destruction. Traditional therapy includes mechanical debridement; however, subgingival pathogens persist in complex biofilms. Hence photodynamic therapy using photosensitizers for elimination of subgingival pathogens is being widely studied. Indocyanine green is one such photosensitizer which when used along with lasers has shown promising results. Photosensitizer bioavailability is found to be better when used in the form of nanoparticles.

OBJECTIVE

This study aimed to evaluate the efficacy of photodynamic therapy (PDT) using indocyanine green (ICG) loaded chitosan nanoparticles (CS-NPs) as an adjunct to scaling and root planing (SRP) in patients with chronic periodontitis.

METHODS

In this randomized controlled interventional study, 40 patients with moderate to severe periodontitis were randomly allocated into test (SRP + PDT) and control (SRP alone) groups. ICG-CS-NPs were applied locally and activated with 810 nm diode laser. Clinical parameters (plaque index-PI, gingival index-GI, probing pocket depth-PPD, and clinical attachment level-CAL) were recorded at baseline and 3 months. Subgingival plaque samples were analysed for colony forming units (CFU).

RESULTS

In both the treatment groups there was a significant improvement in all the clinical parameters from baseline to 3 months. When intergroup comparisons were made the test group showed a statistically significant improvements in probing pocket depth, clinical attachment level as well as colony forming units (CFU) of Porphyromonas gingivalis (Pg) & Aggregatibactor actinomycetemcomitans (Aa) at 3 months post therapy.

CONCLUSION

Chitosan (CS) encapsulated ICG- Nanoparticles mediated PDT when used as an adjunct to SRP in the treatment of chronic periodontitis patients can render improvements in clinical as well as microbiological parameters. CS-ICG-NP can be considered as an alternative to conventional photosensitizers used in PDT for the treatment of chronic periodontitis.