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. 2024 May 22;14(3):954-964.
doi: 10.3390/clinpract14030076.

Efficacy of Non-Surgical Periodontal Therapy with Adjunctive Methylene Blue and Toluidine Blue O Mediated Photodynamic in Treatment of Periodontitis: A Randomized Clinical Trial

Kashan Kamal Najm  1 , Sarhang Sarwat Gul  1   2 , Ali Abbas Abdulkareem  3
Affiliations

Efficacy of Non-Surgical Periodontal Therapy with Adjunctive Methylene Blue and Toluidine Blue O Mediated Photodynamic in Treatment of Periodontitis: A Randomized Clinical Trial

Kashan Kamal Najm et al. Clin Pract. .

Abstract

Background: This study aimed to examine the efficacy of methylene blue (MB) and toluidine blue O (TBO) photodynamic therapy (PDT) as adjuncts to root surface debridement (RSD).

Methods: This split-mouth, randomized, controlled clinical trial included eighteen patients, and a total of 332 sites (control = 102, MB = 124 and TBO = 106) were examined. Two sessions of PDT were completed at baseline and two weeks after RSD. Clinical parameters of bleeding on probing (BOP), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were measured pre- and post-treatment.

Results: PPD and BOP reductions in sites treated by RSD with adjunctive photosensitizers (MB and TBO) were significantly higher than in control sites. RSD with MB showed higher efficacy in improving moderately deep pockets (OR 3.350), while adjunctive TBO showed better results in treating deeper pockets (OR 4.643).

Conclusions: Results suggested that adjunctive use of MB and TBO to RSD could significantly improve periodontal pocket closure and reduce signs of inflammation. In addition, TBO seems to be more efficient in treating deep periodontal pockets than MB, which is more effective in resolving shallower pockets.

Keywords: methylene blue; periodontal therapy; periodontitis; photodynamic therapy; toluidine blue O.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Steps of applying PDT: (A) Probing of test sites at the baseline. (B) Dye injection into the periodontal pockets. (C) Irrigation of the dye at the test sites. (D) Irradiation with light.
Figure 2
Figure 2
Intragroup comparisons of (A) plaque index (PI), (B) bleeding on probing (BOP), and (C) clinical attachment level (CAL). All treatments significantly improved periodontal parameters. ** p < 0.002, *** p < 0.001 using paired t-tests.
Figure 3
Figure 3
Intergroup comparisons of (A) plaque index (PI), (B) bleeding on probing (BOP), and (C) clinical attachment level (CAL). No significant differences in periodontal parameters were observed between sites treated with adjunctive photosensitizers and controls. The only exception was BOP after 3 months, when controls exhibited significantly higher scores than MB and TBO. ** p < 0.002, *** p < 0.001 using Friedman’s test.
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