The application of antimicrobial photodynamic therapy (aPDT, 670 nm) and diode laser (940 nm) as adjunctive approach in the conventional cause-related treatment of chronic periodontal disease: a randomized controlled split-mouth clinical trial



The aim of the present randomized controlled split-mouth clinical trial is to evaluate the effectiveness of the adjunctive use of photodynamic low-level laser therapy (670 nm), applying methylene blue as photosensitizer, and the effectiveness of a diode laser (940 nm) compared with conventional non-surgical mechanical treatment in a group of patients with chronic periodontal disease.

Materials and methods

Twenty-one patients with moderate to severe periodontal disease with presence of 3 or more quadrants, each containing at least three sites with periodontal pocket depth (PPD) of ≥ 5 mm, were included in the study. Periodontal treatment comprising scaling and root planing (SRP) was accomplished for the whole mouth. Applying a split-mouth design, each quadrant was randomly treated with SRP alone (control group), SRP with diode laser (diode group), and SRP with photodynamic therapy (photodynamic group).


All treatment modalities in this study lead to statistically significant improvements in the evaluated clinical parameters at 3 months and 6 months compared with baseline. There was no statistically significant difference regarding PD and BOP between groups. There was only a tendency for greater reduction of PD in the diode group for deep pockets at 3 months, but not statistically significant.


After 6 months of evaluation, the high intensity diode laser and the antimicrobial photodynamic therapy have not shown any additional benefits to the conventional periodontal treatment.

Clinical relevance

The diode or photodynamic laser therapy in conjunction with conventional SRP does not seem to be superior in reducing probing depth and bleeding on probing than SRP alone 6 months after treatment. More studies are necessary to prove the actual need of these types of lasers in the periodontal clinical practice.

This is a preview of subscription content, access via your institution.


  1. 1.

    Cobb CM (1996) Non-surgical pocket therapy: mechanical. Ann Periodontol 1:443–490

    Article  Google Scholar 

  2. 2.

    Rabbani GM, Ash MM Jr, Caffesse RG (1981) The effectiveness of subgingival scaling and root planing in calculus removal. J Periodontol 52:119–123

    Article  Google Scholar 

  3. 3.

    Adriaens PA, Edwards CA, De Boever JA, Loesche WJ (1988) Ultrastructural observations on bacterial invasion in cementum and radicular dentin of periodontally diseased human teeth. J Periodontol 59:493–503

    Article  Google Scholar 

  4. 4.

    Aoki A, Sasaki K, Watanabe H, Ishikawa I (2004) Lasers in non-surgical periodontal therapy. Periodontology 2000(36):59–97

    Article  Google Scholar 

  5. 5.

    Cobb CM (2017) Lasers and the treatment of periodontitis: the essence and the noise. Periodontol 75(1):205–295

    Article  Google Scholar 

  6. 6.

    Aykol G, Baser U, Maden I, Kazak Z, Onan U, Tanrikulu-Kucuk S (2011) The effect of low-level laser therapy as an adjunct to non-surgical periodontal treatment. J Periodontol 82:481–488

    Article  Google Scholar 

  7. 7.

    Kreisler M, Al Haj H, d’Hoedt B (2005) Clinical efficacy of semiconductor laser application as an adjunct to conventional scaling and root planing. Lasers Surg Med 37:350–355

    Article  Google Scholar 

  8. 8.

    Qadri T, Miranda L, Tunér J, Gustafsson A (2005) The short-term effects of low-level lasers as adjunct therapy in the treatment of periodontal inflammation. J Clin Periodontol 32:714–719

    Article  Google Scholar 

  9. 9.

    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

    Article  Google Scholar 

  10. 10.

    Makhlouf M, Dahaba MM, Tuner J, Eissa SA, Harhash TA (2012) Effect of adjunctive low level laser therapy (LLLT) on nonsurgical treatment of chronic periodontitis. Photomed Laser Surg 30:160–166

    Article  Google Scholar 

  11. 11.

    Cappuyns I, Cionca N, Wick P, Giannopoulou C, Mombelli A (2012) Treatment of residual pockets with photodynamic therapy, diode laser, or deep scaling. A randomized, splitmouth controlled clinical trial. Lasers Med Sci 27:979–986

    Article  Google Scholar 

  12. 12.

    de Micheli G, de Andrade AK, Alves VT, Seto M, Pannuti CM, Cai S (2011) Efficacy of high intensity diode laser as an adjunct to non-surgical periodontal treatment: a randomized controlled trial. Lasers Med Sci 26:43–48

    Article  Google Scholar 

  13. 13.

    Euzebio Alves VT, de Andrade AK, Toaliar JM, Conde MC, Zezell DM, Cai S, Pannuti CM, De Micheli G (2013) Clinical and microbiological evaluation of high intensity diode laser adjutant to non-surgical periodontal treatment: a 6-month clinical trial. Clin Oral Investig 17:87–95

    Article  Google Scholar 

  14. 14.

    Soukos NS, Goodson JM (2011) Photodynamic therapy in the control of oral biofilms. Periodontology 2000(55):143–166

    Article  Google Scholar 

  15. 15.

    Takasaki AA, Aoki A, Mizutani K, Schwarz F, Sculean A, Wang CY, Koshy G, Romanos G, Ishikawa I, Izumi Y (2009) Application of antimicrobial photodynamic therapy in periodontal and peri-implant diseases. Periodontology 2000(51):109–140

    Article  Google Scholar 

  16. 16.

    Braun A, Dehn C, Krause F, Jepsen S (2008) Short-term clinical effects of adjunctive antimicrobial photodynamic therapy in periodontal treatment: a randomized clinical trial. J Clin Periodontol 35:877–884

    Article  Google Scholar 

  17. 17.

    Andersen R, Loebel N, Hammond D, Wilson M (2007) Treatment of periodontal disease by photodisinfection compared to scaling and root planing. J Clin Dent 18:34–38

    PubMed  Google Scholar 

  18. 18.

    Ge L, Shu R, Li Y, Li C, Luo L, Song Z, Xie Y, Liu D (2011) Adjunctive effect of photodynamic therapy to scaling and root planing in the treatment of chronic periodontitis. Photomed Laser Surg 29:33–37

    Article  Google Scholar 

  19. 19.

    Birang R, Shahaboui M, Kiani S, Shadmehr E, Naghsh N (2015) Effect of nonsurgical periodontal treatment combined with diode laser or photodynamic therapy on chronic periodontitis: a randomized controlled split-mouth clinical trial. J Lasers Med Sci 6(3):112–119

    Article  Google Scholar 

  20. 20.

    Balata ML, Andrade LP, Santos DB et al (2013) Photodynamic therapy associated with full-mouth ultrasonic debridement in the treatment of severe chronic periodontitis: a randomized-controlled clinical trial. J Appl Oral Sci 21(2):208–214

    Article  Google Scholar 

  21. 21.

    Nguyen N-T, Byarlay MR, Reinhardt RA, Marx DB, Meinberg TA, Kaldahl WB (2015) Adjunctive non-surgical therapy of inflamed periodontal pockets during maintenance therapy utilizing diode laser: a randomized clinical trial. J Periodontol 86:1133–1140

    Article  Google Scholar 

  22. 22.

    Mettraux G, Hüsler J (2011) Implementation of transgingival antibacterial photodynamic therapy (PDT) supplementary to scaling and root planing. A controlled clinical proof-of-principle study. Schweiz Monatsschr Zahnmed 121(1):53–67

    PubMed  Google Scholar 

  23. 23.

    Preber H, Bergström J (1985) Occurrence of gingival bleeding in smoker and non-smoker patients. Acta Odontol Scand 43(5):315–320

    Article  Google Scholar 

Download references


The work was supported by the Department of Preventive Dentistry, Periodontology and Implant Biology and the Department of Operative Dentistry, Dental School of Aristotle University of Thessaloniki, Greece.

Author information



Corresponding author

Correspondence to Fotios Katsikanis.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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

Katsikanis, F., Strakas, D. & Vouros, I. The application of antimicrobial photodynamic therapy (aPDT, 670 nm) and diode laser (940 nm) as adjunctive approach in the conventional cause-related treatment of chronic periodontal disease: a randomized controlled split-mouth clinical trial. Clin Oral Invest 24, 1821–1827 (2020).

Download citation


  • Periodontitis, chronic
  • Diode laser
  • Photodynamic therapy
  • Photosensitizing agent