Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

The effect of photobiomodulation therapy on nonsurgical periodontal treatment in patients with type 2 diabetes mellitus: a randomized controlled, single-blind, split-mouth clinical trial

  • 125 Accesses


Photobiomodulation therapy (PBMT) is a method currently used in the treatment of hard and soft tissue injuries due to its accelerating and enhancing effects on healing. In this study, we aimed to evaluate the possible additional benefits of applying PBMT with nonsurgical periodontal treatment in type 2 diabetes mellitus (DM) patients with chronic periodontitis (CP). Twenty-two type 2 DM patients with CP were enrolled in this clinical split-mouth study. Probing pocket depth (PPD), gingival index (GI), plaque index (PI), and clinical attachment level (CAL) were measured by intracaliber clinician (H.G.) at baseline and at 1 m, 3 m, and 6 m after treatment. Gingival crevicular fluid (GCF) samples were collected at baseline and at 1 week and 1 m, 3 m, and 6 m after treatment. According to split-mouth design, one randomly selected quadrant was treated with PBMT + nonsurgical periodontal treatment (NSPT) and the other quadrant was treated only non-surgical periodontal treatment. PBMT was applied the test quadrant on NSPT day and first, third, and seventh day after treatment at an energy density of 7.64 J/cm2. Repeated measures analysis of variance test was used for the intragroup comparison and a “paired t test” in the intergroup comparison of the clinical and laboratory findings. Comparing the test and control quadrant after treatment, the test quadrant showed significant decrease in PPD at 1 month, 3 months, and 6 months; in GI at 3 months and 6 months; in CAL at month 6; in GCF at 1 week, 1 month, 3 months, and 6 months; and in IL-1β data at 3 months in comparison to the control quadrant. In contrast, there was no statistically significant difference in PI data at all times. Within the limitation of this study, adjunct use of PBMT on NSPT in patient with DM may positively affect the clinical and biochemical parameters.

This is a preview of subscription content, log in to check access.


  1. 1.

    (1999) The pathogenesis of periodontal diseases. J Periodontol 70:457–70. 10.1902/jop.1999.70.4.457

  2. 2.

    Kinane DF, Attström R (2005) Advances in the pathogenesis of periodontitis. Group B consensus report of the fifth European Workshop in Periodontology. J Clin Periodontol 32(Suppl 6):130–131. https://doi.org/10.1111/j.1600-051X.2005.00823.x

  3. 3.

    Kocher T, König J, Borgnakke WS et al (2018) Periodontal complications of hyperglycemia/diabetes mellitus: epidemiologic complexity and clinical challenge. Periodontol 2000(78):59–97. https://doi.org/10.1111/prd.12235

  4. 4.

    Phillips LS, Ratner RE, Buse JB, Kahn SE (2014) We can change the natural history of type 2 diabetes. Diabetes Care 37:2668–2676. https://doi.org/10.2337/dc14-0817

  5. 5.

    Mealey BL, Oates TW (2006) Diabetes mellitus and periodontal diseases. J Periodontol 77:1289–1303. https://doi.org/10.1902/jop.2006.050459

  6. 6.

    Genco RJ, Borgnakke WS (2013) Risk factors for periodontal disease. Periodontol 2000 62:59–94. https://doi.org/10.1111/j.1600-0757.2012.00457.x

  7. 7.

    Lindhe J, Westfelt E, Nyman S et al (1984) Long-term effect of surgical/non-surgical treatment of periodontal disease. J Clin Periodontol 11:448–458

  8. 8.

    Heitz-Mayfield LJA (2000) Lang NP (2013) Surgical and nonsurgical periodontal therapy. Learned and unlearned concepts, Periodontol. https://doi.org/10.1111/prd.12008

  9. 9.

    Gündoğar H, Şenyurt SZ, Erciyas K et al (2016) The effect of low-level laser therapy on non-surgical periodontal treatment: a randomized controlled, single-blind, split-mouth clinical trial. Lasers Med Sci. https://doi.org/10.1007/s10103-016-2047-z

  10. 10.

    Caruso U, Nastri L, Piccolomini R et al (2008) Use of diode laser 980 nm as adjunctive therapy in the treatment of chronic periodontitis. A randomized controlled clinical trial. New Microbiol 31:513–518

  11. 11.

    Saygun I, Nizam N, Ural A (2012) Low-level laser irradiation affects the release of basic fibroblast growth factor (bFGF), insulin-like growth factor-I (IGF-I), and receptor of IGF-I (IGFBP3) from osteoblasts. … laser Surg.

  12. 12.

    Saygun I, Karacay S, Serdar M (2008) Effects of laser irradiation on the release of basic fibroblast growth factor (bFGF), insulin like growth factor-1 (IGF-1), and receptor of IGF-1 (IGFBP3) from gingival. Lasers Med. …

  13. 13.

    Peplow PV, Chung T-Y, Baxter GD (2010) Laser photobiomodulation of proliferation of cells in culture: a review of human and animal studies. Photomed Laser Surg 28(Suppl 1):S3–S40. https://doi.org/10.1089/pho.2010.2771

  14. 14.

    Hakki SS, Bozkurt SB (2012) Effects of different setting of diode laser on the mRNA expression of growth factors and type I collagen of human gingival fibroblasts. Lasers Med Sci 27:325–331. https://doi.org/10.1007/s10103-010-0879-5

  15. 15.

    Park JJ, Kang KL (2012) Effect of 980-nm GaAlAs diode laser irradiation on healing of extraction sockets in streptozotocin-induced diabetic rats: a pilot study. Lasers Med Sci 27:223–230. https://doi.org/10.1007/s10103-011-0944-8

  16. 16.

    Obradović R, Kesić L, Mihailović D et al (2012) Low-level lasers as an adjunct in periodontal therapy in patients with diabetes mellitus. Diabetes Technol Ther 14:799–803. https://doi.org/10.1089/dia.2012.0027

  17. 17.

    Löe H (1967) The gingival index, the plaque index and the retention index systems. J Periodontol 38:610–616. https://doi.org/10.1902/jop.1967.38.6.610

  18. 18.


  19. 19.

    Saglam M, Kantarci A, Dundar N, Hakki SS (2014) Clinical and biochemical effects of diode laser as an adjunct to nonsurgical treatment of chronic periodontitis: a randomized, controlled clinical trial. Lasers Med Sci 29:37–46. https://doi.org/10.1007/s10103-012-1230-0

  20. 20.

    The Research S and TC of TAA of P (2000) Diabetes and periodontal diseases. Committee on Research, Science and Therapy. American Academy of Periodontology. J Periodontol 71:664–678. https://doi.org/10.1902/jop.2000.71.4.664

  21. 21.

    Genco RJ (1996) Current view of risk factors for periodontal diseases. J Periodontol 67:1041–1049. https://doi.org/10.1902/jop.1996.67.10.1041

  22. 22.

    Engebretson SP, Hey-Hadavi J, Ehrhardt FJ et al (2004) Gingival crevicular fluid levels of interleukin-1beta and glycemic control in patients with chronic periodontitis and type 2 diabetes. J Periodontol 75:1203–1208. https://doi.org/10.1902/jop.2004.75.9.1203

  23. 23.

    Shoelson SE, Lee J, Goldfine AB (2006) Inflammation and insulin resistance. J Clin Invest 116:1793–1801. https://doi.org/10.1172/JCI29069

  24. 24.

    Taylor GW, Burt BA, Becker MP et al (1996) Severe periodontitis and risk for poor glycemic control in patients with non-insulin-dependent diabetes mellitus. J Periodontol 67:1085–1093. https://doi.org/10.1902/jop.1996.67.10s.1085

  25. 25.

    Sanz M, Teughels W (2008) Innovations in non-surgical periodontal therapy: Consensus Report of the Sixth European Workshop on Periodontology. J Clin Periodontol 35:3–7. https://doi.org/10.1111/j.1600-051X.2008.01256.x

  26. 26.

    Pejcic A, Zivkovic V (2007) Histological examination of gingiva treated with low-level laser in periodontal therapy. J Laser Appl:7

  27. 27.

    Lai SML, Zee K-Y, Lai MK, Corbet EF (2009) Clinical and radiographic investigation of the adjunctive effects of a low-power He-Ne laser in the treatment of moderate to advanced periodontal disease: a pilot study. Photomed Laser Surg 27:287–293. https://doi.org/10.1089/pho.2007.2206

  28. 28.

    Makhlouf M, Dahaba MM, Tunér J et al (2012) Effect of adjunctive low level laser therapy (PBMT) on nonsurgical treatment of chronic periodontitis. Photomed Laser Surg 30:160–166. https://doi.org/10.1089/pho.2011.3069

  29. 29.

    Moritz A, Schoop U, Goharkhay K et al (1998) Treatment of periodontal pockets with a diode laser. Lasers Surg Med 22:302–311

  30. 30.

    Romanos GE, Henze M, Banihashemi S et al (2004) Removal of epithelium in periodontal pockets following diode (980 nm) laser application in the animal model: an in vitro study. Photomed Laser Surg 22:177–183. https://doi.org/10.1089/1549541041438597

  31. 31.

    Slot DE, Jorritsma KH, Cobb CM, Van der Weijden FA (2014) The effect of the thermal diode laser (wavelength 808-980 nm) in non-surgical periodontal therapy: a systematic review and meta-analysis. J Clin Periodontol 41:681–692. https://doi.org/10.1111/jcpe.12233

  32. 32.

    Al-Zahrani MS, Bamshmous SO, Alhassani AA, Al-Sherbini MM (2009) Short-term effects of photodynamic therapy on periodontal status and glycemic control of patients with diabetes. J Periodontol 80:1568–1573. https://doi.org/10.1902/jop.2009.090206

  33. 33.

    Macedo Gde O, Novaes AB, Souza SLS et al (2014) Additional effects of aPDT on nonsurgical periodontal treatment with doxycycline in type II diabetes: a randomized, controlled clinical trial. Lasers Med Sci 29:881–886. https://doi.org/10.1007/s10103-013-1285-6

  34. 34.

    Qadri T, Bohdanecka P, Tunér J et al (2007) The importance of coherence length in laser phototherapy of gingival inflammation: a pilot study. Lasers Med Sci 22:245–251. https://doi.org/10.1007/s10103-006-0439-1

  35. 35.

    Aykol G, Baser U, Maden I et al (2011) The effect of low-level laser therapy as an adjunct to non-surgical periodontal treatment. J Periodontol 82:481–488. https://doi.org/10.1902/jop.2010.100195

  36. 36.

    Dukić W, Bago I, Aurer A, Roguljić M (2013) Clinical effectiveness of diode laser therapy as an adjunct to non-surgical periodontal treatment: a randomized clinical study. J Periodontol 84:1111–1117. https://doi.org/10.1902/jop.2012.110708

  37. 37.

    Liu Y-CG, Lerner UH, Teng YT (2010) Cytokine responses against periodontal infection: protective and destructive roles. Periodontol 2000 52:163–206. https://doi.org/10.1111/j.1600-0757.2009.00321.x

  38. 38.

    Correa FOB, Gonçalves D, Figueredo CMS et al (2008) The short-term effectiveness of non-surgical treatment in reducing levels of interleukin-1beta and proteases in gingival crevicular fluid from patients with type 2 diabetes mellitus and chronic periodontitis. J Periodontol 79:2143–2150. https://doi.org/10.1902/jop.2008.080132

  39. 39.

    Navarro-Sanchez AB, Faria-Almeida R, Bascones-Martinez A (2007) Effect of non-surgical periodontal therapy on clinical and immunological response and glycaemic control in type 2 diabetic patients with moderate periodontitis. J Clin Periodontol 34:835–843. https://doi.org/10.1111/j.1600-051X.2007.01127.x

Download references


The authors wish to thank Prof. Mehmet Tarakçıoğlu and Research Assistant Hasan Ulusal for their help with the gingival crevicular fluid cytokines analysis and thank Assoc. Prof. Seval Kul for her help with statistical analysis.


This study was supported by a grant from the Gaziantep University Research Foundation (number DHF.15.04), Gaziantep, Turkey.

Author information

Correspondence to Hasan GÜNDOĞAR.

Ethics declarations

This clinical trial was approved by local ethics committee of the University of Gaziantep (date 09.06.2014 per decision no 210), and all the participants were given information about the research, and oral and written informed consent was obtained from all participants. All procedures performed in the present study were in accordance with the Helsinki declaration.

Conflict of interest

The authors declare that they have no conflicts of interest in publishing this article.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

ÖZBERK, S.S., GÜNDOĞAR, H., ÖZKAYA, M. et al. The effect of photobiomodulation therapy on nonsurgical periodontal treatment in patients with type 2 diabetes mellitus: a randomized controlled, single-blind, split-mouth clinical trial. Lasers Med Sci 35, 497–504 (2020). https://doi.org/10.1007/s10103-019-02897-z

Download citation


  • Photobiomodulation
  • Type 2 diabetes mellitus
  • Chronic periodontitis
  • Cytokine
  • Non-surgical periodontal treatment