Efficacy of mechanical debridement with adjunct antimicrobial photodynamic therapy for the management of plaque-induced gingivitis in patients undergoing clear aligner therapy and fixed orthodontic therapy.

OBJECTIVE

The aim is to compare the efficacy of mechanical debridement (MD) with and without adjunct antimicrobial photodynamic therapy (aPDT) for the management of plaque-induced gingivitis among patients undergoing clear aligner therapy (CAT) and fixed orthodontic therapy (OT).

METHODS

This randomized controlled clinical trial included adults with gingivitis undergoing active OT. Participants were randomly stratified into CAT (n = 25) and fixed OT (n = 25) groups, then subsequently to receive either MD alone or MD+aPDT. The aPDT protocol consisted of 0.01% methylene blue photosensitizer activated with a 660-nm diode laser. Plaque index (PI), gingival index (GI), and probing depth (PD) were recorded at baseline and at 1 and 3 months of follow-up. Group comparisons and linear regression analysis were performed. Statistical significance was established at P < 0.05.

RESULTS

Fifty participants completed the study. At one-month follow-up, patients undergoing CAT demonstrated significant reductions in PI, GI, and PD compared with baseline (P < 0.05). However, these improvements were not maintained at the three-month evaluation, and no significant differences were observed between MD alone and MD with adjunct aPDT. Among patients undergoing fixed OT, no significant improvements in PI, GI, or PD were observed at either follow-up interval irrespective of the treatment modality. Linear regression analysis revealed a significant positive association between the duration of fixed OT and periodontal parameters, including PI (P < 0.01), GI (P < 0.01), and PD (P < 0.01).

CONCLUSION

MD with or without adjunct aPDT demonstrated limited efficacy in the management of gingivitis among patients undergoing CAT or fixed OT. The findings suggest that when oral hygiene status remains compromised, the clinical benefits of MD and adjunctive aPDT are unlikely to be sustained.