Photodynamic therapy for the treatment of grade B periodontitis: a systematic review of randomized controlled trials

• Published in: Lasers in medical science Vol. 40; no. 1; p. 327
• Main Authors: Feng, Wei, Khattak, Yasir Rehman, Majeed, Amir A., Shah, Zainab, Hasan, Uzma Saeed, Ahmad, Iftikhar
• Format: Journal Article
• Language: English
• Published: London Springer London 26.07.2025; Springer Nature B.V
• Subjects: Antibiotics; Antimicrobial agents; Biofilms; Clinical outcomes; Clinical trials; Debridement; Dentistry; Diabetes; Endodontics; Female; Females; Guidelines; Gum disease; Heterogeneity; Humans; Infections; Intervention; Lasers; Male; Males; Medical Subject Headings-MeSH; Medicine; Medicine & Public Health; Optical Devices; Optics; Patients; Periodontitis; Periodontitis - drug therapy; Photochemotherapy - methods; Photodynamic therapy; Photonics; Photosensitizing Agents - therapeutic use; Planing; Quantum Optics; Randomized Controlled Trials as Topic; Review; Statistical analysis; Systematic review; Treatment Outcome; Bleeding on probing; Clinical attachment loss; Antimicrobial therapy; Periodontitis; Probing pocket depth
• ISSN: 1435-604X; 0268-8921; 1435-604X
• DOI: 10.1007/s10103-025-04576-8

Objectives This systematic review evaluates the efficacy of photodynamic therapy (PDT) compared to conventional treatments in Grade B periodontitis. Methods A comprehensive electronic search was conducted across PubMed, Google Scholar, Dimensions, Ebase, X-mole, and Semantic Scholar, following the PRISMA guidelines. Only randomized controlled trials (RCTs) comparing PDT with conventional periodontal treatments were included. Primary clinical outcomes included probing pocket depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BOP). Results Data from 26 RCTs involving 753 patients were analyzed, with PDT applied in 219 patients (130 males, 109 females) and conventional treatment in 314 patients (173 males, 141 females). PDT significantly reduced PPD (2.6–5.23 mm) and CAL (1.26–6.00 mm), showing comparable or superior outcomes to scaling and root planing (SRP) in several RCTs. Despite these promising results, heterogeneity in photosensitizer type, laser wavelength (660–810 nm), energy dose, and PDT session protocols contributed to variability in outcomes. Conclusion PDT demonstrates significant clinical benefits in Grade B periodontitis treatment, particularly in PPD reduction, CAL improvement, and BOP control. However, variability in treatment protocols and limited long-term follow-up data (median: 6 months) highlight the need for standardized guidelines and further high-quality RCTs.