Efficacy of Photodynamic Therapy as an Adjunct to Non-Surgical Debridement in the Treatment of Peri-Implant Mucositis: An Original Research Study

Aim

This study aims to determine the efficacy of photodynamic therapy as an adjunct to non-surgical debridement in the treatment of peri-implant mucositis Materials and Methods: This clinical study evaluated the efficacy of antimicrobial photodynamic therapy (aPDT) as an adjunct to mechanical debridement for treating peri-implant mucositis. Forty adult patients (aged 35–60) with clinical signs of inflammation, probing pocket depths 4 mm, and no radiographic bone loss were randomised into two groups. The control group received mechanical debridement with a sham laser, while the test group received mechanical debridement followed by aPDT (Toluidine or Methylene Blue photosensitizer incubated for 1–3 minutes and irradiated with a 660/680 nm diode laser for 60–120 seconds). Clinical outcomes,including bleeding on probing (primary), probing depth, plaque index, clinical attachment level, microbiological reduction, and cytokine levels, were statistically analysed at 3 and 6 months. Statistical Analysis and Results: This study evaluated and compared mechanical debridement (MD) alone (Group 1) versus MD with adjunctive antimicrobial photodynamic therapy (aPDT) (Group 2) at 3 and 6 months. At 6 months, Group 2 demonstrated superior clinical outcomes over Group 1, showing greater reductions in probing depth (3.10±0.38 mm vs. 3.91±0.98 mm) and clinical attachment level (4.30±0.39 mm vs. 5.88±0.58 mm). Gingival recession remained stable in both cohorts. Group 2 also experienced a sharper decline in bleeding on probing (from 48.50% to 28.60%) and lower peri-implant osteolytic potential. Suppuration at 6 months resolved more effectively in Group 2 (16.0%) than Group 1 (25.0%).Biochemically, Group 2 exhibited lower concentrations of inflammatory biomarkers IL-1 and IL-6 at both intervals. TNF levels remained comparable between groups, while Matrix Metalloproteinase (MMP) levels showed a steeper decline in Group 2 by month 6. Overall, combining MD with aPDT improves clinical and biochemical periodontal parameters compared to MD alone.