Antimicrobial photodynamic therapy using chloro‐aluminum phthalocyanine for treating advanced stage‐III periodontitis in smoking patients

Abstract Purpose To evaluate the bacterial, clinical, and cytokine profile of adjunctive photodynamic therapy using chloro‐aluminum phthalocyanine (CAP/aPDT) with root surface debridement (RSD) versus RSD alone in cigarette smokers (CS) and never‐smokers (NS) during the period of 6 months. Methods Twenty‐nine patients [CS – 14 and NS – 15] were recruited for the trial having stage‐III periodontitis. All candidates from the study groups were subjected to a split‐mouth treatment technique receiving CAP/aPDT + RSD and RSD alone. Periodontal parameters including plaque levels (PL), bleeding on probing (BP), probing depth (PD), clinical attachment loss (CAL), and marginal bone loss (MBL) were assessed. Polymerase chain reaction (qPCR) assay was used to analyze the copy numbers of Porphyromonas gingivalis ( Pg ) and Tannerella forsythia ( Tf ). Levels of tumor necrosis factor‐alpha (TNF‐α) interleukin (IL)‐6 in the crevicular fluid were evaluated by enzyme‐linked immunosorbent assay (ELISA). Results CAP/aPDT+RSD decreased BP in smokers after 6 months ( p < .05). Probing depth and CAL reported statistically significant reductions within both CAP/aPDT+RSD and RSD groups and also within the NS and CS ( p < .05). Pg and Tf stayed elevated in smokers at the 6‐month evaluation period ( p < .01). Only CAP/aPDT+RSD significantly decreased Pg and Tf at 3‐ and 6‐month follow‐up in smokers ( p < .05). CAP/aPDT+RSD showed decreased IL‐6 levels in the NS during the 6‐month follow‐up ( p < .01). TNF‐α levels were significantly reduced in the CS group with CAP/aPDT+RSD and RSD alone until 6 months ( p < .01). Conclusion CAP‐mediated aPDT along with nonsurgical periodontal therapy helped to improve the bacteriological outcomes among smokers and never‐smokers with stage‐III CP patients.