Indocyanine green doped with chitosan nanoparticles based antimicrobial photodynamic therapy in periodontitis patients: A randomized clinical trial
Year: 2026
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: BACKGROUND Periodontitis is a chronic inflammatory disease triggered by a polymicrobial challenge to the periodontium. While scaling and root planing (SRP) is the gold standard for treatment, its efficacy is often limited by incomplete pathogen eradication and rising antimicrobial resistance. Antimicrobial photodynamic therapy (aPDT) has emerged as a potent adjunctive treatment, utilizing light-activated photosensitizers to induce targeted bacterial lysis. Specifically, the delivery of indocyanine green (ICG) via chitosan nanoparticles (CNPs) may enhance stability and penetration, offering a synergistic approach to improving clinical outcomes when combined with SRP. AIM To evaluate the overall improvements in various clinical and microbiological periodontal parameters in periodontitis patients undergoing aPDT with CNPs-ICG. METHODS Thirty periodontitis patients having interdental clinical attachment loss (CAL) ‘detectable’ at ≥ 2 non-adjacent teeth, buccal or oral CAL ≥ 3 mm with pocketing > 3 mm detectable at ≥ 2 teeth were randomly assigned to aPDT with CNPs-ICG + SRP (test) group and conventional SRP + laser irradiation only (control) group in a split-mouth design. At baseline, 1-month and 3-months plaque index (PI), modified sulcular bleeding index, pocket probing depth (PPD) and relative clinical attachment level (RCAL) and microbiological tests were recorded. RESULTS The test group showed more improvement in PPD (7 mm to 3.26 mm in 1-month and 3.13 mm in 3-months) and RCAL (12 mm to 8.26 mm in 1 month and 8.4 mm in 3 months) than control group that showed PPD reduction from 6.7 mm (at baseline) to 3.73 mm at 1-month and 3.76 mm at 3 months and RCAL reduction from 12.23 mm (at baseline) to 8.7 mm at 1-month and 8.9 mm at 3-months with a statistically significant difference (P = 0.001). The test sites showed a statistically significant (P = 0.001) increase in negative microbiological test results (from 10% at baseline to 80% at 1 month and 3 months follow-up) compared to control sites (6.7% at both baseline and 1-month and 3-months follow-up). CONCLUSION aPDT using CNPs-ICG + SRP can be considered as a better procedure in improving periodontal clinical parameters like PPD and RCAL and in reducing periodontal pathogens than conventional SRP alone.
Authors: Subash Chandra Raj, Sudip Sen, Debajani Baral, Devapratim Mohanty, Shaheda Tabassum, Swoyangprava Sil, Mrutyunjaya Sahu
Language: English
Subfield: Periodontics
Field: Dentistry
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7135368463