EFFICACY OF PHOTODYNAMIC THERAPY IN THE COMPREHENSIVE TREATMENT OF CHRONIC PERIODONTITIS BASED ON CLINICAL PARAMETERS

Abstract

Objective. The aim of the study is to assess the clinical and microbiological efficacy of photodynamic therapy (PDT) as an adjunctive method in the comprehensive treatment of chronic periodontitis, as well as to evaluate its effectiveness in patients with concomitant systemic diseases, particularly uncontrolled diabetes mellitus. Research methods. A systematic analysis of current randomized controlled trials and meta-analyses (2021–2025) conducted using a split-mouth design and parallel groups was performed. The studies determined the periodontal pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), and plaque index (PI) before and after therapy in the short term (3–6 months) and medium term (6–12 months). Microbiological assessment was performed by determining the number of pathogenic anaerobic microorganisms (Porphyromonas gingivalis). PDT was applied using indocyanine green (ICG, 810–830 nm) in combination with standard mechanical therapy (SRP), and where necessary, in combination with regenerative or oxygen-releasing methods. Results. PDT significantly reduced PPD by 1.2–1.5 mm, increased CAL by 0.7–1.1 mm, and decreased BOP by 18–25%. The number of pathogenic anaerobes in the biofilm decreased by up to 60%. In patients with systemic diseases, the effect remained clinically significant. The most pronounced improvement was observed during the first three months after treatment. The scientific novelty of the study lies in the comprehensive synthesis of contemporary evidence regarding the effectiveness of photodynamic therapy in the treatment of chronic periodontitis, the refinement of its clinical and microbiological effects in patients with concomitant systemic diseases, and the substantiation of the feasibility of implementing personalized treatment protocols based on individual clinical characteristics of patients. Conclusions. PDT effectively enhances the outcomes of comprehensive periodontitis treatment and supports the implementation of personalized therapeutic protocols. Future research should focus on protocol standardization, long-term effect assessment, combined use with regenerative and oxygen-releasing methods, and integration of PDT into digital personalized treatment planning systems.